Sealer Placement Research Articles

Presence and distribution of voids after using the single cone obturation technique with different sealer placement methods in canals with an isthmus

Background/purposeThe obturation of canals with irregular structures is still a challenge for single cone obturation technique (SC). The purpose of this study was to evaluate the presence and distribution of voids using SC with different sealer placement methods in the canal with a simulated band-shaped isthmus. Materials and methods3D-printed root canal models with band-shaped isthmuses were randomly divided into four groups according to different obturation methods. Group 1: sealer placement by single cone passively (SCP); Group 2: bi-directional spiral-supported sealer placement (BS); Group 3: ultrasound-supported sealer placement (U). Group 4: vertical compaction obturation (VC). In each group, 10 of 14 models were sliced and the remaining four were scanned by micro-CT. The percentage area of voids (PAV) and the percentage volume of voids (PVV) of fillings were calculated. ResultsAt all slice levels, using BS and U to support sealer placement reduced voids with an average PAV of 21%, and in the VC and SCP groups were 33% and 45% respectively. Based on the micro-CT scans, nearly half of the porosity decreased by the BS and ultrasound in the isthmus with PVV of 25% and 29% respectively, compared with 46% in the SCP group. However, in the main canal, when the PVV was 22% in the SCP group, the porosity decreased to 14% in the U group and 18% in the BS group. ConclusionBi-directional spiral or ultrasound-supported sealer placement can improve the performance of single cone obturation in canals with an isthmus.

Evaluation of the Impact of Calcium Silicate-Based Sealer Insertion Technique on Root Canal Obturation Quality: A Micro-Computed Tomography Study.

Calcium silicate-based sealers have gained in popularity over time due to their physicochemical/biological properties and their possible use with single-cone obturation. The single cone technique is a sealer-based obturation and there is still a knowledge gap regarding the potential impact of the sealer insertion method on the root canal-filling quality. Therefore, the aim of this micro-CT study was to assess the impact of the calcium silicate-based sealer insertion technique on void occurrence and on the sealer extrusion following single-cone obturation. Thirty-six single-rooted mandibular premolars with one canal were shaped with Reciproc® R25 (VDW, Munich, Germany) then divided randomly into four groups of nine canals, each depending on the TotalFill® BC Sealer insertion technique used with single cone obturation: injection in the coronal two-thirds (group A); injection in the coronal two-thirds followed by direct sonic activation (group B); injection in the coronal two-thirds followed by indirect ultrasonic activation on tweezers (group C); sealer applied only on the master-cone (control group D). Samples were then scanned using micro-CT for voids and sealer extrusion calculation. Data were statistically analyzed using v.26 IBM; Results: No statistically significant differences were noted between the four groups in terms of voids; nevertheless, sonic activation (group B) followed by ultrasonic activation on the tweezers (group C) showed the best results (p = 0.066). Group D showed significantly less sealer extrusion when compared with group C (p = 0.044), with no statistically significant differences between groups D, A and B (p > 0.05). Despite no significant differences observed between the different sealer placement techniques, the use of sonic and ultrasonic activation might be promising to reduce void occurrence. Further investigations are needed to demonstrate the potential benefit of calcium silicate-based sealer activation especially in wide and oval root canals in order to improve the quality of the single-cone obturation.

Comparative Evaluation of the Sealing Ability of a BioCeramic Sealer (iRoot SP) with AH Plus Sealer with Root Canal Dentin Using Three Different Techniques of Sealer Application: A Combined Dye Extraction and Scanning Electron Microscope Study

The adaptation of a sealer along with the periphery of the dentinal tubules of the root canal is studied. Various techniques have been used for the application of these sealers onto the canal wall for better adaptation but have not been compared to date. The purpose of the study was to comparatively evaluate the sealing ability of a bioceramic sealer with AH plus sealer with root canal dentin using three different techniques for the application of sealer. One hundred twenty extracted maxillary and mandibular anterior teeth were collected, disinfected, and decoronated at the cemento-enamel junction to maintain a standard working length for all samples. The establishment of the working length (40.10) and instrumentation was performed using a rotary instrument, along with a standard irrigation regimen. The teeth were then divided into two main groups according to the sealer used, i.e., Group A (AH Plus) and Group B (iRoot SP). These two main groups were categorized into three sub-groups depending on the technique of sealer placement, i.e., Subgroup 1 (master cone gutta-percha), Subgroup 2 (bidirectional spiral), and Subgroup 3 (passive ultrasonic activation). Out of the 20 samples, 15 samples were randomly allocated for the assessment of sealing ability using the routine dye extraction method, and to verify the results of the dye extraction method, a more advanced evaluation method, i.e., SEM evaluation, was utilized further. To this end, five random samples from each subgroup were allocated for SEM analysis. The obtained scores were then statistically analyzed using an ANOVA test and Post Hoc Tukey’s test. In the current study, statistical significance was seen among the three main groups and six subgroups with p-values < 0.005. Subgroup B3 performed significantly better than the other subgroups in both the dye extraction method as well as in SEM analysis. The highest microleakage was shown by subgroup A1; it also exhibited poor penetration of sealer in SEM evaluation. The bioceramic sealer (iRoot SP), when applied using passive ultrasonic activation, showed the best results in both the dye extraction method and the SEM evaluation.

Effect of different sealer activation techniques on dentinal tubule penetration.

The aim of this study was to evaluate the influence of different activation techniques on dentin tubule penetration of root canal sealer. Seventy-five teeth with single canals were chemomechanically prepared. A calcium silicate-based sealer was stained with a fluorescent dye (rhodamine B), placed into the canals and activated according to the following groups: control (no activation), EDDY, EndoActivator, ultrasonic and XP-Endo Finisher. Then, the samples were obturated. The percentages of sealer penetration at various depth levels of root sections were measured with confocal laser scanning microscopy. XP-Endo Finisher presented the highest penetration at 50 μm (p < 0.05). XP-Endo Finisher showed similar penetration with EDDY at 100 and 200 μm (p > 0.05) while presented higher penetration than the other groups (p < 0.05). At 500 μm, XP-Endo Finisher presented higher penetration than EndoActivator (p < 0.05) while similar penetration with the other groups (p > 0.05). XP-Endo Finisher can be recommended for activation during sealer placement for better penetration into dentin tubules.

Do resin-based sealers increase post-operative pain following root-canal treatment?

Design Systematic review. Case selection This systematic review had a focused and structured research question in term of PICO (Population, Intervention, Comparison and Outcomes). Patients included within the study were those with undergoing primary root canal treatment on a permanent tooth. The intervention was obturation with gutta percha and a resin-based sealer in comparison to obturation with gutta percha and another sealer type. The primary outcome being measured was post-operative pain incidence and/or intensity. An additional, secondary outcome, aimed to assess analgesic intake following treatment.Data analysis Data analysis was carried out by two independent reviewers using a specifically designed template which gave a concise summary of the study included within the review. The form allowed the following details to be recorded: whether a single operator completed treatment; pulpal status; irrigants used; sealer placement technique and type; obturation technique and quality; evaluation time; and outcome measures. An assessment was carried out of each study to ascertain the risk of bias which was categorised as low risk, having some areas of concerns or high risk.Six studies were included within the quantitative analysis which involved analysis of post-operative pain experiences at specified intervals. Qualitative data analysis was completed using a digital software package which allowed comparable results to be combined.Results The results from this systematic review demonstrated no significant difference in post-operative pain incidence between endodontic treatment using resin or non-resin sealers. While seven of the studies had high risk of overall bias, four were deemed low risk, and the majority of studies confirmed that there was no significant difference in the intensity of pain between the two groups. This review also confirmed that analgesic intake is not increased in patients where resin-based sealers are used when compared to non-resin sealers.Conclusion There is no significant difference in post-operative pain when resin-based root canal sealers are used when compared to other root canal sealers. For both resin and non-resin sealers, analgesics use, pain incidence post-operatively and intensity of pain reduce after 24 hours.

Retrievability of Calcium Silicate–based Root Canal Sealers During Retreatment: An Ex Vivo Study

IntroductionThe retrievability of calcium silicate–based sealers (CSSs) during nonsurgical retreatment has been equivocal. This study compared the retrievability of 3 different CSSs using 1 of 3 different solutions or no solution. MethodsA total of 130 extracted teeth with a straight canal were decoronated to a standardized root length. The canals were instrumented to 35/.04 and divided into 3 groups (BC: EndoSequence BC sealer; EBC: EdgeBioceramic; NEO: NeoSEALERFlo), and each group was further divided into 4 subgroups (6% sodium hypochlorite; 5% acetic acid; carbonated water; no solution). After sealer placement, each master gutta-percha cone was placed intentionally 2 mm short of the working length (WL) to ensure the apical 2 mm was filled only with sealer. After storage for 21 days at 37°C and 100% humidity, retreatment was performed until apical patency was obtained. The operator was blinded to the CSS and solution used. Data were analyzed using analysis of variance to compare apical patency rates and the mock chair-times. ResultsOverall success rates for apical patency in BC, EBC, and NEO were 63.64%, 69.77%, and 100%, respectively. There was significantly higher apical patency rate in NEO than BC and EBC. The chair-time for NEO was significantly shorter than BC (P < .05) and EBC sealer (P < .001). There was no significant difference in the chair-time between BC and EBC sealer groups. ConclusionBC, EBC, and NEO sealers in a straight canal were consistently retrievable when no solution was used. Compared with no solution, the retrievability of BC, EBC, and NEO decreased when solutions were used.

The Short-Term Antibacterial Activity of Three Selected Endodontic Sealers against Enterococcus faecalis Bacterial Culture.

(1) Background: Microorganisms originating from the microflora of the oral cavity are the main cause of the inflammatory diseases of the dental pulp and periapical periodontium, as well as the failure of endodontic treatment. The subsequent root canal treatment is not able to remove all the pathogens, and a small number of viable bacteria remain in the dentine tubules, which must be sealed by endodontic sealers. These sealers should have at least a bacteriostatic effect to prevent the remaining bacteria from reproducing. The aim of this study is to compare the short-term antibacterial activity of three endodontic sealers based on poly-epoxy resin, zinc oxide-eugenol and calcium silicate with a calcium hydroxide-based sealer. Calcium hydroxide is used as temporary intracanal medicament and, thus, should show significant antibacterial activity. (2) Methods: A total of 25 bovine dentine samples infected with Enterococcus faecalis were used in this study. After the sealer placement and a 24 h incubation period, the root canal walls were scraped, and the suspension of dentine fillings was used for a semi-quantitative evaluation of microbial growth. (3) Results: The poly-epoxide resin-based sealer ADSeal™ showed significant antibacterial properties. (4) Conclusions: The highest antibacterial activity was shown in poly-epoxide resin-based sealer group, followed by the zinc oxide-eugenol-based sealer and calcium silicate-based sealer.

The presence of smear layer affects the antimicrobial action of root canal sealers.

To assess the chemical and microstructural characteristics of dentine after the use of two irrigation protocols and correlate this with the antimicrobial properties of hydraulic calcium silicate cement (HCSC) sealers and changes to the dentine structure/chemistry after sealer placement. Two irrigation protocols - Protocol A using 2% NaOCl used 5mL/5min and Protocol B with 2% NaOCl (5mL/5min) followed by 17% EDTA (5mL/3min) - were used to prepare dentine. The chemical and microstructural changes following irrigation were assessed by scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS) and Fourier transform infrared (FT-IR) spectroscopy (n=5) on dentine obtained from the mid-root and coronal parts of extracted human teeth. Four sealers (AH Plus, BioRoot, MTA Fillapex, TotalFill) were characterized by SEM/EDS (n=3). The ability of the sealers to eradicate intratubular Enterococcus faecalis biofilms was assessed by live/dead dye and confocal laser scanning microscopy to measure the percentage of living cells. The effect of combined irrigation and root filling on dentine was assessed by SEM and EDS analysis (n=5). Statistical analysis was undertaken using one-way anova and a number of post hoc tests to detect intergroup differences. The F-test was used for comparison of variances in the microbiology testing. The use of NaOCl alone left the smear layer intact, with traces of chlorine remaining on dentine. The use of BioRoot sealer restored the calcium levels of dentine which had been depleted by the irrigation with EDTA. BioRoot exhibited antimicrobial properties against intratubular bacteria even in the presence of smear layer (Protocol A). Smear layer removal improved the bactericidal effect of all sealers and Ca2+ leaching. The use of a chelating agent was important for the intratubular sealer penetration for AH Plus but not the other sealers. The removal of smear layer was necessary for penetration of AH Plus into the dentinal tubules. BioRoot was a more effective sealer in reducing the bacterial load in the dentinal tubules than the other materials tested and the presence of smear layer did not affect its activity.

A matched irrigation and obturation strategy for root canal therapy

In root canal therapy, irrigating solutions are employed to eliminate the bacterial load and also prepare dentin for sealer interaction. The aim of this research was to assess how irrigating solutions employed on their own or in sequence affected the tooth structure. The best way to prepare the tooth for obturation using hydraulic calcium silicate cement (HCSC) sealers and gutta-percha, thus guiding clinicians on a matched irrigation-obturation strategy for optimized root canal treatment was investigated. The effect of irrigating solutions on dentine was investigated by assessing changes in dentin microhardness, ultrastructure and mineral content, organic/inorganic matter, surface roughness and Young’s modulus. The interaction of four root canal sealers with the dentin was analysed by assessing the changes in microhardness of the dentin after sealer placement and also the sealer to dentin interface by scanning electron and confocal laser microscopy. The irrigating solutions damaged the dentin irreversibly both when used on their own and in combination. The best sequence involved sodium hypochlorite followed by chelator and a final rinse with sodium hypochlorite and obturation using HCSC sealers that enabled the restoration of dentin properties. The HCSC sealers did not rely on chelator irrigating solutions for a good material adaptation to dentin.

Filling of small oval root canals: influence of sealer placement and filling technique.

<p>Objectives: The aim of this study was to carry out a morphometric analysis of small oval root canals filled with GuttaFlow 2 sealer (Coltène/Whaledent) using different methods of sealer placement and different root canal filling techniques.<br /> Method and materials: Eighty extracted mandibular incisors with small oval root canals were instrumented with the Self-Adjusting File (Redent Nova). GuttaFlow 2 was placed using a lentulo spiral, paper point, master point, or sonically activated CanalBrush (Coltène/Whaledent), followed by the placement of a master point and accessory points (M?P+) (part 1). GuttaFlow 2 was placed using a lentulo spiral without a gutta-percha point, together with a single point, with a chloroform-dipped master point, or the latter with accessory points (ChMP+) (part 2). Serial cuts were made at 1-mm intervals up to 10&nbsp;mm. The percentages of gutta-percha filled area (PGFA), sealer, voids, and debris were evaluated using interactive image analysis software.<br /> Results: For part 1 of the study (sealer placement), significant differences regarding PGFA at 2 and 5&nbsp;mm from the apex were found, whereas for part 2 (filling technique), significant differences were found at all levels besides 2 and 4&nbsp;mm (Kruskal-Wallis test, P&nbsp;=&nbsp;.05). ChMP+ reached 85% PGFA at 3&nbsp;mm from the apex, but only 30% near the apex. The MP+ groups showed a relatively equal distribution of PGFA by 60% to 80% at different levels. GuttaFlow 2 without a gutta-percha point exhibited significantly more voids and debris than the other groups (Kruskal-Wallis test, P&nbsp;=&nbsp;.05).<br /> Conclusion: Within the limits of this study, MP+ could be recommended for clinical use. The presence of voids and debris for the group without a gutta-percha point needs further investigation.</p>.

External root surface temperature changes during high-temperature injectable thermoplasticized root canal obturation in simulated immature teeth

Introduction: The present study evaluated the change in the temperature of the external root surface of simulated immature teeth obturated with high-temperature injectable thermoplasticized gutta-percha. Materials and Methods: Root canals of 60 mandibular premolars were enlarged till size # 6 peeso freely passed through the apex. After placement of an apical barrier of 4 mm of mineral trioxide aggregate (MTA), two K-type thermocouples were attached at middle and apical thirds. The canals were obturated using high-temperature injectable thermoplasticized gutta-percha with either no sealer; AH plus sealer; or MTA Fillapex sealer. Maximum temperature rise was measured and evaluated. The data were analyzed using two-way ANOVA test. Results: The temperature increased after 4 s of placement of heated gutta-percha. There was no significant effect of sealer placement on the peak rise in temperature at the middle third (P Conclusions: The use of thermoplasticized gutta-percha can significantly increase the temperatures on the external root surface.

Influence of passive ultrasonic tip activation at different levels on the depth of sealer penetration: An in vitro study

Introduction: The aim of this study was to compare the effect between different levels of ultrasonic tip activation on the depth of epoxy resin-based sealer (AH plus) dentinal tubules penetration. Materials and Methods: Extracted single-rooted premolars (n = 60) were randomly allocated into three groups and instrumented following the same protocol. Group 1 (control), the sealer was mixed with 0.1% Rhodamine B dye and placed using size 20 K-file. In Group 2, the sealer was passively activated using ultrasonic tip (ISO 25) 10 s mesiodistally and buccolingually at 2 mm from the apex. In Group 3, the sealer was activated in a similar manner at 4 mm from the apex. Samples were sectioned horizontally at 2 mm, 4 mm, and 6 mm from the apex and analyzed using a stereomicroscope for tubular dentine sealer penetration. The cross-sectional area (μm2) was measured with software to get the percentage of sealer penetration, and presences of voids were recorded. Results: Significant lesser percentage of sealer penetration into the dentinal tubules was observed between the control group and both the experimental groups (P = 0.00) at 2 mm, 4 mm, and 6 mm from the apex. There was no significant difference in the percentage of sealer penetration into the dentinal tubules between both the experimental groups (P > 0.05). The presence of voids between all groups was not statistically significant (P > 0.05). Conclusion: Passive ultrasonic activation of sealer placement resulted in deeper sealer penetration into the dentinal tubules even at a higher level of tip activation (4 mm).

In vitro evaluation of bond strength of sealers after using various irrigants and Erbium-Yttrium-Aluminum-Garnet laser irradiation on radicular dentin surface: A SEM study

Aim: The aim of this in vitro study was to evaluate and compare the push-out bond strength of Adseal and mineral trioxide aggregate (MTA) Fillapex sealer after using various irrigants and Erbium-Yttrium-Aluminum-Garnet (Er:YAG) laser irradiation on radicular dentin surface. Materials and Methods: A total of 80 freshly extracted human permanent maxillary anterior teeth were sectioned transversally below the cemento-enamel junction. The remaining root portion was sectioned to get 4-mm thick dentin disc from coronal end of the root, with straight handpiece, and diamond disc. Root canal of specimens was prepared with bur to create space for sealer placement. Specimens were divided into eight groups of 10 samples each, as per irrigants and sealer used. In Group 1, 3, 5, and 7 specimens irrigated with distilled water, NaOCl, Ethylenediaminetetraacetic acid (EDTA), and Er:YAG laser, respectively, and obturated with Adseal sealer. In Group 2, 4, 6, and 8 irrigated with distilled water, NaOCl, EDTA, and Er:YAG laser, respectively, and obturated with MTA Fillapex sealer. After sealer setting, the force used to remove the sealer was evaluated using universal testing machine. Recorded force used to calculate the push-out bond strength in Megapascals and scanning electron microscopy examination was done for specimens. Results: Adseal sealer had significantly higher bond strength than MTA Fillapex sealer, irrespective of irrigant used. The highest bond strength was seen in specimens irrigated with EDTA and obturated with Adseal sealer and least in specimens irrigated with distilled water and obturated with MTA Fillapex sealer. Conclusion: Adseal sealer had significantly higher bond strength than the MTA Fillapex sealer. EDTA irrigation showed better smear layer removal, followed by Er:YAG laser irradiation, then NaOCl, least by distilled water.

Tooth crown discoloration induced by endodontic sealers: a 3-year ex vivo evaluation.

The aim of this study was to evaluate the tooth crown discoloration induced by commonly used and new-generation endodontic sealers after 1month and 1 and 3years. The crowns of 60 extracted incisors were cut and the pulp chambers were cleaned. The specimens were divided randomly into four groups (n = 15 each). Pulp chambers were filled with Pulpispad in group 1, AH26 in group 2, MTA Fillapex in group 3, and EndoREZ in group 4. Specimen color was measured with a spectrophotometer before and after sealer placement. Commission International de L'Eclairage's (CIE's) lighteness (L*), red-green (a*), yellow-blue (b*) color system values and color difference (ΔE) were recorded at 1month and 1 and 3years. Data were analyzed using repeated-measures analysis of variance and Tukey's honestly significant difference test (α =0.05). All sealers caused discoloration. At 1month, ΔE values were significantly higher in groups 1 and 2 than in groups 3 and 4 (p< 0.05). At 1year, ΔE values were significantly lower in group 3 than in the other groups (p< 0.05). At 3years, ΔE values were significantly higher in group 1 than in the other groups (p< 0.05). All tested sealers induced varying chromatic alterations. After root canal obturation, thorough debridement of sealers from the pulp chamber is essential for the prevention of sealer-induced discoloration. Tooth discoloration induced by endodontic materials is a problem for clinicians and patients and may impair the esthetic of endodontically treated teeth. Therefore, evaluation of long-term discoloration effects commonly used, and new-generation endodontic sealers were purposed in this study.

Effectiveness of different final irrigation techniques and placement of endodontic sealer into dentinal tubules

The aim of this study was to compare two irrigation techniques and four devices for endodontic sealer placement into the dentinal tubules. Ninety-nine single-rooted human teeth were instrumented and allocated to either the control (CO) (n=11) or experimental groups according to the irrigation method: syringe and NaveTip needle (NT) (n=44), and EndoActivator (EA) (n=44). These groups were subdivided according to sealer placement into K-File (KF), lentulo spiral (LS), Easy Clean (EC), and EndoActivator (EA) subgroups. Moreover, the distances of 5 mm and 2 mm from the apex were analyzed. The teeth were obturated with AH Plus and GuttaCore X3. Analyses were performed by scanning electron microscopy associated to cathodoluminescence. The percentage and maximum depth of sealer penetration were measured. Data were evaluated by three-way analysis of variance (ANOVA) and Games-Howell test (p<0.05). EA was superior to NT in percentage of sealer penetration. EC was significantly superior to EA (subgroup) for sealer penetration, and both improved the percentage of sealer penetration when compared to LS. Better sealer penetration was observed at the distance of 5 mm from the apex. Sealer penetration into the dentinal tubules was significantly improved by sonic irrigant activation.

Comparison of Three Different Sealer Placement Techniques: An In vitro Confocal Laser Microscopic Study.

Introduction:Three-dimensional obturation of the root canal system is the final objective of root canal therapy. Greater penetration of sealer in root dentine lesser will be the voids at the dentine–sealer interface. Hence, analysis of the dentin/sealer interface allows the determination of a filling technique which could obturate the root canals with least gaps and voids. Therefore, the aim of this study is to compare the depth and percentage of sealer penetration into root dentin using three different root canal sealer placement techniques under confocal laser scanning microscope.Materials and Methods:Thirty single-rooted teeth were selected and prepared. Adseal sealer (Meta Biomed, South Korea) was mixed with Rhodamine B dye and applied using lentulo spiral (Dentsply Maillefer, USA) as Group 1, bidirectional spiral (EZ-Fill– EDS, USA) as Group 2, and ultrasonic endodontic tip (Sonofile– Dentsply Tulsa, USA) as Group 3. Canals were then obturated with gutta-percha. The roots were sectioned at the 3 and 6-mm levels from the apical foramen and examined under confocal laser microscope.Results:Maximum mean depth and percentage of sealer penetration were observed for Group 1 and minimum for Group 3. Furthermore, statistical significant differences among Group 1 and Group 3 were found at 6-mm level and among Group 2 and Group 3 were found at 3-mm level (P < 0.05).Conclusion:The depth and percentage of sealer penetration of sealer are influenced by the type of placement technique and by the root canal level, with penetration decreasing apically. Lentulo spiral has shown better penetration of sealer than the bidirectional file and ultrasonics.

Evaluating the quality of seal of root canals in the presence of separated rotary instrument when obturated with different obturation techniques using liquid photospectrometry

Introduction: Complete sealing of the root canal system is essential for the successful outcome of the endodontic treatment. unfortunately instrument may separate during biomechanical preparation and achieving a fluid tight seal may be difficult. Three dimensional obturation thus plays an important role in achievement of fluid tight in presence of separated rotary instruments. To evaluate the quality of seal of root canals in the presence of separated rotary instrument when obturated with different obturation techniques using liquid photospectrometry. Materials and Methods: One hundred and twenty freshly extracted mandibular human premolars with straight and single root canal were selected. The preparations of canal were completed by single file system with primary file size 25/08 (WaveOne system, Dentsply Maillefer, Switzerland). The roots were randomly assigned into two groups: Group I (n = 60) and Group II (n = 60). Group I (n = 60) was subdivided into three subgroups A, B, and C. Group A (n = 20): Roots were obturated with lateral condensation technique without sealer placement and without instrument being separated at apical third. Group B (n = 20): Roots were obturated with lateral compaction technique using epoxy resin based sealer (AH Plus) placed in canals without instrument being separated at apical third. Group C (n = 20): Roots were obturated with lateral compaction technique using epoxy resin-based sealer (AH Plus) placed along the root canals with instrument being separated at apical third. Group II (n = 60) was also subdivided into three subgroups A, B, and C with twenty roots in each subgroup. In subgroups A, B, and C of Group II, the same methodology was used, except obturation was done using thermoplasticized Gutta-percha (Calamus, Dentsply Maillefer, Switzerland). The modified glucose penetration setup was used and samples were then analyzed with a spectrophotometer (ELICO SL 244-double beam ultraviolet-visible) at 340 nm wavelength. Statistical analysis was done using descriptive and inferential statistics using Student's paired and unpaired t-test and softwares used in the analysis were SPSS 17.0 version and GraphPad Prism 5.0 version and P Results: Significant variation was found in mean glucose leakage in groups obturated with lateral condensation and thermoplasticized Gutta-percha (t = 2.10, P = 0.042). Conclusions: Leakage observed with thermoplasticized obturation was less when compared to lateral condensation. Three-dimensional obturation plays a crucial role than the separated instrument during endodontic therapy.

A Comparative in vitro Study to Evaluate Sealer Distribution using Bidirectional Spiral and Traditional Sealer Placement Techniques

A Comparative in vitro Study to Evaluate Sealer Distribution using Bidirectional Spiral and Traditional Sealer Placement Techniques

Combined Antibacterial Effect of Sodium Hypochlorite and Root Canal Sealers against Enterococcus faecalis Biofilms in Dentin Canals

IntroductionThe present study aimed to evaluate the antibacterial effect of the combined use of sodium hypochlorite (NaOCl) and root canal sealers on Enterococcus faecalis biofilms using a dentin infection model. MethodsCells of E. faecalis were introduced into the dentinal tubules by centrifugation and incubated in brain-heart infusion for 3 weeks. The biofilms in dentin were first subjected to 5% NaOCl or sterile water for 10 minutes followed by an equal thickness of AH Plus (Dentsply International Inc, York, PA), Endosequence BC Sealer (Brasseler USA, Savannah, GA), or MTA Fillapex (Angelus Indústria de Produtos Odontológicos S/A, Londrina, Brazil) placed on the root canal wall of the dentin specimens for 7, 30, and 60 days. Gutta-percha and water were used in a similar manner as controls. The proportions of dead and live bacteria inside the dentinal tubules were assessed by confocal laser scanning microscopy and viability staining. ResultsThe combined use of NaOCl and sealers (30 and 60 days) killed significantly more bacteria than NaOCl or sealers alone (P < .05). NaOCl + MTA Fillapex was the most effective antibacterial combination by killing 83% bacteria in dentin tubules in 60 days. Thirty and 60 days of exposure to the sealers resulted in significantly more dead bacteria in dentin biofilms than 7-day exposures (P < .05). ConclusionsThe placement of root canal sealer after NaOCl treatment enhanced antibacterial effects against E. faecalis in the dentinal tubules. Little additional effect was obtained after 30 days of exposure to sealers.

Influence of sealer placement technique on the quality of root canal filling by lateral compaction or single cone.

The aim of this study was to evaluate the influence of the sealer placement technique on the quality of root canal filling using Lateral Compaction (LC) or Single Cone (SC). In order to do that, 60 mesial roots of mandibular first molars were prepared and divided into 2 groups (n=30), according to the filling technique: LC and SC. Each group was subdivided into 3 subgroups (n=10), according to the different sealer placement methods: A: Master gutta-percha (GP) cone; B: Lentulo spiral; C: File. The roots were sectioned at 2, 4 and 6 mm from the apex and photographed with the aid of a digital microscope. Then, areas of GP, endodontic sealer and voids were measured, and these data were subjected to statistical analysis. LC technique showed no statistically difference (p>0.05) in the percentage of GP area, sealer and voids between the subgroups at any of the three levels. After use of SC, higher percentages of sealer area were found at all levels (p<0.01) when the sealer was placed with a file. At 2 mm, higher percentage of void areas (p<0.05) was observed when the cone was used, lower percentage with K-file and the lowest percentage with Lentulo. At 4 mm, cone showed higher percentage of void areas (p<0.05). At 6 mm, there were no significant differences (p>0.05) between the three methods. Considering these results, using an instrument for sealer placement was important in the SC technique to reduce voids. Regarding LC, the sealer placement techniques provided similar results.