AH26 Sealer Research Articles

In vitro comparison of the marginal adaptation of cold ceramic sealer with the single-cone obturation technique versus AH-26 sealer with the lateral compaction technique in single-canal teeth

ObjectivesThis study aimed to compare the marginal adaptation of a cold ceramic (CC) sealer with the single-cone obturation technique with that of an AH-26 sealer with the lateral compaction technique in single-canal teeth.Materials and methodsIn this in vitro experimental study, the root canals of 24 extracted single-rooted single-canal teeth were instrumented to F3 files by the crown-down technique and randomly assigned to 2 groups (n = 12). The root canals were obturated with a CC sealer and single-cone obturation technique with 4% gutta-percha in group 1 and with an AH-26 sealer and lateral compaction technique with 2% gutta-percha in group 2. After 4 weeks of storage at room temperature and 100% humidity, the root ends were sectioned horizontally 3 mm from the apex, and the mean linear distance between the root filling material and the root dentinal wall was measured under a scanning electron microscope (SEM). Comparisons were made by the Mann‒Whitney test (alpha = 0.05).ResultsThe mean linear distance (gap) was significantly smaller in the CC sealer/single-cone group than the AH-26/lateral compaction group (6.72 ± 2.57 vs. 12.94 ± 4.82 μm, P = 0.001).ConclusionMarginal adaptation was significantly higher with the CC sealer and single-cone obturation technique than with the AH-26/lateral compaction technique, suggesting the suitability of the CC sealer and single-cone obturation technique for a hermetic seal in single-canal teeth.

Tissue Reaction Elicited by Neosealer Flo, AH 26, and CC Sealer in Rats

Background: Since root canal sealers are in contact with periradicular tissues, biocompatibility is one of their most important features .There is no available study about the biocompatibility of NSF and CC Sealer that are newly made bioceramic-based sealers. This study aimed to compare the tissue reaction elicited by NeoSealer Flo (NSF), AH26, and ColdCeramic Sealer (CC sealer) in rats. Material and Methods: The sealers were mixed and applied in molds to fabricate sealer discs, which were then implanted in the subcutaneous tissue of the backs of 30 healthy adult Albino Wistar rats. Each rat received three sealer discs and the fourth incision site remained empty as a control group. After 7, 30, and 90 days, the rats were sacrificed. Biopsy samples were evaluated regarding the extent and severity of inflammation, angiogenesis, fibroplasia, and infiltration. Data were analyzed in SPSS software using Kruskal-Wallis and Mann-Whitney U tests. Results: Tissue reaction to NSF was generally severe and increased up to day 30, but slightly decreased at three months, although it was still severe, and significantly greater than the tissue reaction to other sealer types. After one month, all rats in the NSF group showed foreign body reaction and giant cells around sealer particles; while, foreign body reaction was not seen in other groups. Tissue reaction to CC Sealer and AH26 was not significantly different at any point in time (P>0.05) and was the highest on day seven and then decreased up to month three. Conclusion: According to the present results, the CC Sealer appears to be a biocompatible material; however, NSF showed higher severity and extent of inflammation and triggered higher tissue reaction.

Effect of Cold Plasma on the Penetration Depth of AH26 and Beta Resin Sealers in Dentinal Tubules.

The creation of a proper seal of the root canal with canal-filling materials, such as gutta-percha and sealer, is one of the essential factors in the success of root canal treatment. In addition, the penetration depth of the sealer is one of the influential factors in creating a proper seal, which improves the sealing ability of the canal and the burial of microorganisms. This study aimed to investigate the effect of cold atmospheric plasma on the depth of tubular penetration of two types of resin sealer: AH26 and Beta RCS sealers. In this experimental study, thirty-two premolar teeth with single root and single canal were selected as samples and after cutting their crowns from the apex distance of 15mm, the canals were prepared with rotary files. Samples were divided into four groups of eight, according to the type of sealer and plasma application: AH26 sealer (AH), plasma+AH26 sealer (PAH), Beta RCS sealer (Beta), and plasma+Beta RCS sealer (PBeta). The cold lateral condensation technique was used for the obturation of canals. The maximum penetration depth and the percentage of sealer penetration were obtained from microscopic images at three coronal, middle, and apical sections. Due to the non-normal distribution of data, the Mann-Whitney U test was used for statistical analysis (p< 0.05). No significant difference was observed between the study groups in the penetration percentage and maximum penetration depth of AH and Beta in the presence and absence of plasma. However, in the coronal section, the depth of maximum sealer penetration was significantly higher in the AH group than in the Beta group (p< 0.05). The use of plasma did not affect the maximum penetration depth and penetration percentage of AH26 sealer and Beta RCS sealer.

An In Vitro Comparative Analysis of Physico-Mechanical Properties of Commercial and Experimental Bioactive Endodontic Sealers.

This study aimed to evaluate the fracture resistance of root and sealer penetration after obturation using an epoxy resin sealer AH plus (AH+) and two different bioactive endodontic sealers, i.e., Totalfill BC Hiflow (TF BC), and experimental injectable bioactive glass (Exp.BG). A thermo-sensitive injectable sealer was prepared by using a non-ionic triblock copolymer and bioactive glass. The root canals of human extracted teeth were obturated with the respective sealers. The fracture resistance was analyzed at different time intervals, i.e., days 7, 30, and 90. The morphological and elemental analyses of the fractured roots were conducted with a scanning electron microscopy and a electron dispersive spectroscopy. Sealer penetration depth and the percentage of penetrated sealers into the dentinal tubules were assessed with the confocal laser scanning microscope. Statistical analysis was performed using a one-way ANOVA post hoc Tukey's test. The mean fracture force in AH+ was significantly higher on day 30 (664.08 ± 138.8 N) compared to day 7 (476.07 ± 173.2 N) and day 90 (493.38 ± 120.18 N). There was no statistically significant difference between the TF BC and Exp.BG at different time intervals. The maximum penetration was observed in the middle region compared to coronal and apical for the Exp.BG, followed by the TF BC and AH+ groups; however, a nonsignificant difference in penetration was found over time. It is concluded that the TF BC group showed overall better fracture resistance than AH+ at day 90. Exp.BG showed comparable sealer penetration to those of TF BC and better than those of AH+.

Calcium Silicate-Based Sealers: Apatite Deposition on Root Canal Dentin and pH Variation Analysis

Abstract Objective This study analyzes the biomineralization potential of calcium silicate-based sealers Ceraseal (Meta Biomed Co., Cheongju, Korea) and AH Plus Bioceramic (Dentsply Sirona, United States), focusing on evaluating apatite deposition in root canal dentin and pH increases. Materials and Methods Calcium silicate-based sealers Ceraseal (Meta Biomed Co.) and AH Plus Bioceramic (Dentsply Sirona) were applied to the root canal dentin of premolars that had undergone root canal preparation procedures. This was followed by a 14-day immersion in phosphate-buffered saline (PBS). Biomineralization analysis was performed by analyzing the formation of the apatite layer after the 14-day immersion. The thickness of the apatite layer deposits was observed using a scanning electron microscope (SEM). Additionally, the sealers were placed in molds and submerged in PBS solution with pH measurements taken on days 0, 7, and 14 using a digital pH meter. Statistical Analysis The average thickness of apatite deposition in the interfacial layer was analyzed using the Mann–Whitney's test. The pH value differences among the groups were analyzed using a one-way analysis of variance test, followed by a post hoc least significant difference. Results There were differences in the apatite deposition in the interfacial layer between Ceraseal and AH Plus Bioceramic within 14 days of observation. There was a significant difference (p &lt; 0.05) between the pH values of Ceraseal and AH Plus Bioceramic at 7 and 14 days of observation. Ceraseal showed greater alkalizing activity compared with AH Plus Bioceramic. Conclusion Calcium silicate-based sealer Ceraseal showed better biomineralization potential than AH Plus Bioceramic.

Microleakage Assessment of Single Cone Gutta Percha Obturation Technique Using Different Types of Sealers

This study was carried out to compare the coronal and apical seal of canals obturated with single cone technique using different types of epoxy resin root canal sealers. A total of sixty extracted human upper molars with fully formed and sound palatal roots were used in this study. The crown of each tooth was decoronated at cement-enamel junction and the palatal root canal was prepared using ProTaper gold rotary instruments. Sixty specimens were used and divided into 3 equal groups(n=20) for single cone obturation using two different types of epoxy resin sealers AH26 and vioseal sealers respectively and one control group without sealer. All the specimens were exposed varnish application followed by dye penetration test using 2% methylene blue dye then root sectioning. Samples were evaluated under a stereomicroscope to detect the linear measurement of the dye penetration from the apical constriction. The image transferred to a computer equipped with the image analysis software program where the dye penetration along the filling dentine interface was evaluated. The collected data was statistically analysis by using Graph Pad Instat software for windows. One-way ANOVA was done for compared results followed by Tukey’s pair-wise. The results showed that, the difference in dye penetration microleakage means between groups was statistically significant as revealed by one-way ANOVA test (p &lt; 0.05). Pair-wise Tukey’s post-hoc test showed non-significant (p&gt;0.05) difference between (AH26 and Vioseal sealers) groups. None of the tested root canal sealers could eliminate the dye infiltration or microleakage formation. Single cone gutta-percha combined with AH26 sealer exhibited less microleakage than vioseal sealer although there were no statically significant differences between them.

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.

A three-dimensional cell culture approach to investigate cytotoxic effects and production of inflammatory mediators by epoxy resin-based and calcium silicate-based endodontic sealer.

The aim of the present study was to assess the cytocompatibility of epoxy resin-based AH Plus Jet (Dentsply De Trey, Konstanz, Germany), Sealer Plus (MK Life, Porto Alegre, Brazil), calcium silicate-based Bio-C Sealer (Angelus, Londrina, PR, Brazil), Sealer Plus BC (MK Life) and AH Plus BC (Dentsply) through a tridimensional (3D) culture model of human osteoblast-like cells. Spheroids of MG-63 cells were produced and exposed to fresh root canal sealers extracts by 24h, and the cytotoxicity was assessed by the Lactate Dehydrogenase assay (LDH). The distribution of dead cells within the microtissue was assessed by fluorescence microscopy, and morphological effects were investigated by histological analysis. The secreted inflammatory mediators were detected in cell supernatants through flow luminometry (XMap Luminex). Cells incubated with AH Plus Jet, AH Plus BC, Sealer Plus BC and Bio-C Sealer extracts showed high rates of cell viability, while the Sealer Plus induced a significant reduction of cell viability, causing reduction on the spheroid structure. Sealer Plus and Seaker Plus BC caused alterations on 3D microtissue morphology. The AH Plus BC extract was associated with the downregulation of secretion of pro-inflammatory cytokines IL-5, IL-7, IP-10 and RANTES. The new AH Plus BC calcium silicate-based endodontic sealer did not reduce cell viability in vitro, while led to the downregulation of pro-inflammatory cytokines. Choosing the appropriate endodontic sealer is a crucial step. AH Plus BC demonstrated high cell viability and downregulation of pro-inflammatory cytokines, appearing reliable for clinical use, while Sealer Plus presented lower cytocompatibility.

Physicochemical Changes in Root-Canal Sealers under Thermal Challenge: A Comparative Analysis of Calcium Silicate- and Epoxy-Resin-Based Sealers.

We compared the effects of heat on the physicochemical properties of recently developed calcium silicate-based sealers (CSBSs), including BioRoot Flow, BioRoot RCS, and AH Plus Bioceramic sealer, with those of the epoxy-resin-based sealer (ERBS) AH Plus. The flow, film thickness, setting time, and solubility of sealers were evaluated at 37 °C and 100 °C using ISO 6876/2012. Furthermore, pH and calcium ion release were evaluated at these temperatures. In addition, the mass change in sealers at a high temperature was assessed via thermogravimetric analysis. Then, the chemical composition and components of the sealers were analyzed using a scanning electron microscope and Fourier-transform infrared spectroscopy (FTIR). BioRoot Flow, AH Plus Bioceramic, and AH Plus complied with ISO standards in terms of flow and film thickness, both before and after heat application. However, BioRoot RCS exhibited significantly increased film thickness at 100 °C. The setting times of all sealers were significantly reduced at 100 °C. The solubility of CSBS was >3%, exceeding the ISO 6876/2012 standard, both before and after heat exposure. Conversely, the solubility of AH Plus complied with the standard, regardless of the thermal condition. For 4 weeks, CSBS showed a significantly higher pH than AH Plus at both 37 °C and 100 °C. After heat treatment, calcium release decreased in Bioroot RCS and BioRoot Flow, while AH Plus showed no significant differences before and after treatment. However, CSBS consistently exhibited significantly higher calcium release than AH Plus at both temperatures. An FTIR analysis revealed that the chemical composition of the sealers did not change at the high temperature, whereas a thermogravimetric analysis demonstrated a >5% weight reduction in CSBS and a 0.005% weight reduction in AH Plus at 100 °C. BioRoot Flow, AH Plus Bioceramic, and AH Plus possess favorable physicochemical properties, which make them suitable for application under thermal conditions. At a high temperature, BioRoot RCS did not exhibit changes in its chemical composition. However, its film thickness was increased, and pH and solubility were reduced. Therefore, caution is needed when it is applied at high temperatures, such as during the warm obturation technique.

Premixed calcium silicate-based root canal sealers have better biological properties than AH Plus: A systematic review and meta-analysis of in vivo animal studies and in vitro laboratory studies.

The aim was to determine whether premixed calcium silicate-based root canal sealers have better biological properties than AH Plus. Searches of studies published up to January 2023 were performed in the PubMed/MEDLINE and EMBASE and via other methods (databases of the International Endodontic Journal, Journal of Endodontics, and gray literature). The inclusion criteria were in vivo animal and in vitro studies that analyzed the response in the dorsal subcutaneous tissue of rats, cell viability, and genotoxicity. Systematic Review Centre for Laboratory Animal Experimentation Risk of Bias (RoB) tool for in vivo studies and modified CONSORT checklist for in vitro were appraised. Meta-analysis was performed using the Stata. Fifty-two studies were included. In the RoB, in vivo studies fulfilled 20%-50% of the items and in vitro 60%-100%. The studies included in the meta-analysis demonstrated better histocompatibility with the premixed calcium silicate-based sealers at 30 days and greater cell viability with these sealers when used in undiluted extracts in experimental period of 72 h and in extracts with 1:2 and 1:4 dilution in 24 and 72 h. In contrast, no difference between materials was found concerning genotoxicity. Premixed calcium silicate-based root canal sealers have better histocompatibility and are less cytotoxic than the epoxy resin-based sealer AH Plus, demonstrating favorable biological behavior.

Comparative bioactivity and immunomodulatory potential of the new Bioroot Flow and AH Plus Bioceramic sealer: An in vitro study on hPDLSCs

ObjectivesTo evaluate the cytocompatibility, bioactivity, and anti-inflammatory potential of the new pre-mixed calcium silicate cement-based sealers Bioroot Flow (BrF) and AH Plus Bioceramic Sealer (AHPbcs) on human periodontal ligament stem cells (hPDLSCs) compared to the epoxy resin-based sealer AH Plus (AHP).Materials and methodsStandardized discs and 1:1, 1:2, and 1:4 eluates of BrF, AHPbcs and AHP after setting were prepared. The following assays were performed: cell attachment and morphology via SEM, cell viability via a MTT assay, cell migration/proliferation via a wound-healing assay, cytoskeleton organization via immunofluorescence staining; cytokine release via ELISA; osteo/cemento/odontogenic marker expression via RT-qPCR, and cell mineralized nodule formation via Alizarin Red S staining. HPDLSCs were isolated from extracted third molars from healthy patients. Comparisons were made with hPDLSCs cultured in unconditioned (negative control) or osteogenic (positive control) culture media. Statistical significance was established at p < 0.05.ResultsBoth BrF and AHPbcs showed significantly positive results in the cytocompatibility assays (cell metabolic activity, migration, attachment, morphology, and cytoskeleton organization) compared with a negative control group, while AHP showed significant negative results. BrF exhibited an upregulation of at least one osteo/cementogenic marker compared to the negative and positive control groups. BrF showed a significantly higher calcified nodule formation than AHPbcs, the negative and positive control groups, while AHPbcs was higher than the negative control group. Both were also significantly higher than AHP group.ConclusionBrF and AHPbcs exhibit adequate and comparable cytocompatibility on hPDLSCs. BrF also promoted the osteo/cementogenic differentiation of hPDLSCs. Both calcium silicate-based sealers favored the downregulation of the inflammatory cytokine IL-6 and the calcified nodule formation from hPDLSCs. BrF exerted a significantly higher influence on cell mineralization than AHPbcs.Clinical relevanceThis is the first study to elucidate the biological properties and immunomodulatory potential of Bioroot Flow and AH Plus Bioceramic Sealer. The results act as supporting evidence for their use in root canal treatment.

Comparison of the Antibacterial Effect of AH26, Adseal and Beta RCS Root Canal Sealers against Enterococcus Faecalis, an in Vitro Study.

Objectives: Antibacterial activity against endodontic pathogens is a desirable feature for root canal sealers. The objective of this study was to compare the antibacterial effect of three resin-based endodontic sealers (AH26, Adseal, and Beta RCS) against Enterococcus faecalis in vitro. Materials and Methods: The antibacterial properties of the sealers were assessed against E. faecalis using agar diffusion test (ADT) for fresh state (N=10) and direct contact test (DCT) for freshly-mixed and set states of the materials (N=10). In ADT, the diameter of the zones of inhibition was measured after 24h of contact. In DCT, the colony-forming units of the bacteria were counted after 30 minutes and 180 minutes of exposure. The results were analyzed with two-way ANOVA and independent sample t-test. P<0.05 was considered significant. Results: Regarding DCT results, all test materials indicated an antibacterial effect, both in freshly-mixed and set states. The highest antibacterial effect was related to Adseal, whereas the lowest was observed in Beta RCS. There was a significant difference between all study groups (different sealers, setting states, and contact times; P<0.001), except for freshly-mixed AH26 and Adseal at 180 minutes (P>0.05). According to ADT, AH26 and Adseal represented the widest and the smallest inhibition zones, respectively (P<0.001). Conclusion: Within the limitations of this in vitro study, AH26, Adseal, and Beta RCS showed antibacterial effects against E. faecalis in both freshly-mixed and set states. The antibacterial effect increased over time in all of the studied sealers.

Investigating the Effect of Internal Bleaching With 10% Carbamide Peroxide on the Color Change of Three Types of Common Endodontic Sealers.

Background and purpose Color change caused by materials used for endodontic treatment is an important clinical issue. The current research examined the impact of internal bleaching with 10% carbamide peroxide on discolored teeth resulting from various types of sealers. Materials and methods In this study, 36 anterior teeth were cut from 1 mm beneath the cementoenamel junction (CEJ), and the samples were divided into three groups of 12. Then, AH26 (Tulsa Dental, Tulsa, OK), Endofill (Herpo Produtos Dentários Ltda, Petrópolis, Brazil), and AH Plus (DentsplyDeTrey, Konstanz, Germany) color change potential sealers were placed inside the pulp chamber. The cervical access cavity was covered with a thin layer of glass ionomer. After one month, the material was removed, and bleaching was done with 10% carbamide peroxide. The color of the samples was measured by a spectrophotometer before bleaching, one week after bleaching, and one week after bleaching again. The data were subjected to statistical analysis using the Statistical Package for Social Sciences (SPSS)software version 16 (IBM SPSS Statistics, Armonk, NY), with a significance level set at P<0.05. Results The results showed that the factor of time and material used and the opposing effect of these two on the amount of L and ΔE were statistically significant (P<0.05). After one to two weeks of internal bleaching, all groups showed some degree of reduction in sealer-induced discoloration. In addition, in all groups, the largest difference in L was related to the difference in L0 and L2 (before bleaching and one week after bleaching again), and the lowest difference was related to the difference in L0 and L1. Also, the highest ΔE(T0,T1) belonged to the Endofill group, and this significantly differed from the AH26 group. AH26 showed the lowest value of ΔE(T0,T1), and after two weeks, the ΔE of all groups was higher than the clinically observable limit. The highest ΔE(T2,T0) among the groups belonged to the Endofill group. The ΔE(T2,T0) of AH26 and Endofill was significantly higher than AH Plus. Among all ΔE values, the AH Plus group had the lowest values. Conclusion Color change caused by Endofill and AH26 sealers showed a better response to internal bleaching than the AH Plus sealer.

Physicochemical properties of calcium silicate cement based endodontic sealers

AimTo mensure the physicochemical properties of three ceramic cement endodontic sealers AH Plus Bioceramic, Bio-C Sealer and Bio-C Sealer Ion+ with an epoxy resin sealer, AH Plus. Material and methodsThese properties were measured: hardening time (HT), dimensional change (DC), solubility (SL), flow (FL) and radiopacity (RD). The distilled water obtained from the SL test was analyzed with atomic absorption spectrometry. A sample calculation was made considering n = 5 repetitions for each experimental sealer evaluated. Statistical analysis was performed using one-way ANOVA and post hoc Tukey tests (p < 0.05). ResultsFor the HT, AH Plus (484 ± 2.76 min) and AH Plus Bioceramic (424 ± 1.23 min) set more slowly than of Bio-C Sealer (370 ± 4.50 min) and Bio-C Sealer Ion+ (380 ± 1.42 min) (p < 0.05). AH Plus Bioceramic (12.56 ± 2.71 %) was more soluble than Bio-C Sealer (6.69 ± 1.67 %), Bio-C Sealer Ion+ (5.67 ± 2.16 %) and AH Plus (0.15 ± 0.01 %) (p < 0.05). AH Plus (0.03 ± 0.01 %) had slight expansion while the cement-based sealers had shrinkage: AH Plus Bioceramic (−1.60 ± 0.63 %) and Bio-C Sealer (−1.38 ± 0.69 %), Bio-C Sealer Ion+ (−5.19 ± 1.23 %) (p < 0.05). Bio-C Sealer Ion+ (59.80 ± 0.86 mm) and Bio-C Sealer (58.60 ± 0.98 mm) had the highest flow compared with AH Plus (56.90 ± 0.56 mm) and AH Plus Bioceramic (49.50 ± 0.63 mm) (p < 0.05). AH Plus (9.17 ± 0.06 mmAl) and AH Plus Bioceramic (8.27 ± 0.84 mmAl) showed radiopacity values when compared with those of Bio-C Sealer (4.90 ± 0.08 mmAl) and Bio-C Sealer Ion+ (4.14 ± 0.05 mmAl) (p > 0.05). ConclusionIon release is inhered to these cement-based sealers and this result in calcium ion release.

The effect of AH26, Endoseal and ZOE sealers on Candida albicans and Enterococcus faecalis.

In the oral cavity, root canal treatment failure (endodontics) is often due to the persistence of microorganisms in the root canal system after treatment, or re-infection of the root due to insufficient flooding. In addition, microorganisms are essential for the development of peri radicular diseases and are one of the main factors related to root canal treatment failure. Microorganisms that are commonly isolated from teeth that have failed endodontic treatment include Enterococcus (E.) faecalis and Candida (C.) albicans. Bacterial infection is closely related to the failure of root canal treatment, and the use of root sealer with antimicrobial activity and biological compatibility is necessary for the success of root canal treatment. One of the main goals of endodontic treatment is to eliminate intracanal infection and root canal flooding in order to prevent re-infection. Therefore, the aim of the current study is to evaluate the antibacterial and antifungal activity of ZOE, AH26 and Endoseal sealers in vitro. To study the effect of each sealer; AH26, ZOE and Endoseal on E. faecalis and C. albicans, 10 samples were considered. Firstly, the freshly prepared sealers were poured inside the microtube with nutrient broth and then 10 µl of E. faecalis and C. albicans suspensions were separately added into a microtube and were kept 24 hours in the incubator to grow. The data were analyzed with Kolmogrov-Smirnov test and SPSS Version 19. Our results demonstrated that the resistance rate of C. albicans to ZOE, Endoseal and AH26 sealers was 0%, 100% and 70%, respectively. These values for the E. faecalis was 80%, 100% and 40% respectively. The resistance was defined when the microorganism was growth in subculture in LB agar. ZOE sealer has highest antimicrobial effect after that AH26 sealer and the least antimicrobial effect is related to Endoseal sealer.

Effect of Non-thermal Plasma Therapy on Pushout Bond Strength of Epoxy Resin and Tricalcium Silicate-Based Endodontic Sealers.

Introduction: The current study aimed to assess the effect of non-thermal plasma (NTP) on the pushout bond strength (PBS) of epoxy resin and tricalcium silicate-based endodontic sealers. Methods: Forty single-canal extracted teeth were decoronated at the coronal region, underwent root canal preparation, and were assigned to four groups (n=10) for the application of AH26 sealer, NTP+AH26 (P-AH26), Endoseal TCS sealer, and NTP+Endoseal TCS sealer (P-TCS). The root canals were sectioned into 1 mm slices, and the PBS value was measured in a universal testing machine. Data were analyzed by the Friedman, Kruskal-Wallis, and Dunn tests (P<0.05). Results: The PBS of TCS and P-TCS groups was not significantly different (P>0.05). The PBS of the P-AH26 group was significantly lower than that of the AH26 group in the middle third (P<0.05). The PBS of the AH26 group was higher than the other groups in all sections. The PBS in the apical third was lower than other sections in all groups (P<0.05). Conclusion: NTP had no significant effect on the PBS of Endoseal TCS. NTP significantly decreased the PBS of AH26 sealer in the middle third but had no significant effect on its bond strength in other sections.

Evaluation of Antimicrobial Activity and Cytotoxicity of an Epoxy Resin-Based Endodontic Sealer Containing Nanoparticles Amorphous Calcium Phosphate

Background. The main cause of posttreatment disease in endodontics is the remaining of microorganisms within the root canal walls after endodontic therapy. Therefore, it is essential to use root canal sealers with potent antibacterial properties. These sealers play a vital role in eradicating any remaining microorganisms and preventing recontamination, especially in situations where there might be microleakage. Aim. The objective of this research was to examine the antimicrobial properties of epoxy root canal sealers containing nanoparticle amorphous calcium phosphate (NACP) against planktonic Enterococcus faecalis in a controlled laboratory environment. Furthermore, the study aimed to assess the potential cytotoxic effects of these sealers. Method. In order to determine the antimicrobial activity, the epoxy resin sealer (AH Plus, Dentsply, Germany) was supplemented with NACP from Sigma–Aldrich, at a concentration of 3wt.%, as per the previous flowability tests. The agar well diffusion assay method was employed to evaluate the antibacterial efficacy. For this, cultured plates (n = 8) were prepared, with each plate containing three wells: one with AH Plus, one with AH Plus + NACP, and one with NACP alone. Subsequently, the plates were sited at 37°C in an incubator and allowed to incubate overnight. The width of the inhibition zones was then analyzed and recorded by the SPSS statistical software package (Version 20.0 for Windows, SPSS, Chicago, IL, USA). The cytotoxicity of the NACP incorporated AH Plus and AH Plus sealers were tested indirectly by MTT assay and directly by the multiparametric high content screening toxicology assay using fibroblast-like cells as cell lines. Results. AH Plus + NACP showed a higher antimicrobial activity than AH Plus with significant difference ( P &lt; 0.0001 ). Both materials showed nonsignificant difference compared to negative control, which indicated lower cytotoxicities. For AH Plus, P = 0.3599 , 0.5959 , and 0.4071 , with time intervals 24, 72, and 168 hr, respectively. For AH Plus + NACP, P = 0.4386 , 0.6182 , and 0.2080 , with 24, 72, and 168 hr, respectively. Conclusions. NACP incorporation with epoxy resin sealer AH PLUS had a higher antimicrobial activity with lower cytotoxic effect indicating their potential therapeutic values.

Impact of Heating Exposure on the Micro-Push-Out Bond Strength of Bioceramic Sealers

Introduction. The aim of this study was to evaluate the effect of heating of bioceramic and epoxy resin-based sealers on their micro-push-out bond strength (BS) to root canal dentin. Methods. After criterial selection, 30 human teeth were decoronated and 1-mm thick slices (n = 60) were obtained perpendicularly along tooth axis, from cervical and middle root thirds, with a diamond disc attached to a cutting machine. In each slice, three 1.0-mm diameter orifices were made. After rinsing with 17% EDTA and 2.5% NaOCl, each orifice was filled with Bio-C Sealer or BioRoot RCS or AH Plus, according to the manufacturers’ instructions. After filling, half of the slices (n = 30) were heated at 100°C for 1 min, and the other half were kept at room temperature. After 7 days-controlled storage, micro-push-out test was performed in a Universal Testing Machine. Failures were analyzed using a stereomicroscope. Statistical analysis was performed with One-Way ANOVA and post hoc Tukey (α = 5%) tests. Results. AH Plus demonstrated higher BS values after heating ( p = 0.001 ) when compared to nonheated. The other sealers did not show a statistically significant difference ( p &gt; 0.05 ). When heated, the average BS values for AH Plus were higher than for BioRoot RCS and Bio-C Sealer ( p &lt; 0.001 ). Cohesive failure mode was the most frequent, followed by adhesive and mixed ones. Conclusion. Heating provided a higher push-out BS to root dentin for AH Plus and did not influence BioRoot RCS or Bio-C sealer.

Human Gingival Fibroblasts Response to Different Endodontic Sealers: An In Vitro Study

Endodontic treatment aims to eliminate infection of the root canals and fill the dental pulp space. The biocompatibility studies of the sealers used in root canals obturation are crucial since they are applied in direct contact with periradicular tissues. Objective: The aim of this study was to evaluate the cytotoxicity of three root canal sealers—AH Plus, Bio MTA+, and Bio C sealer—on immortalized human gingival fibroblasts. Methods: AH Plus, Bio MTA+, and Bio C sealers were evaluated through incubation in real-time and material-conditioned media. Cells were incubated for 24 h and 72 h, at three different concentrations (1, 10, and 100 mg/mL) of each sealer. The cytotoxic activity of the sealers was assessed by Methyl tetrazolium (MTT) and Sulforhodamine B (SRB) assays. Cell morphology and cytogenetic alterations were studied microscopically. Results: MTT and SRB assays revealed similar results within both approaches. Cell culture exposed to sealers through incubation in real-time revealed a cytotoxic effect of AH Plus at 100 mg/mL. Material-conditioned media study revealed a cytotoxic effect of Bio MTA+ and Bio C, increasing with higher compound concentration and reaching 50% with 100 mg/mL. Regarding the cell’s morphology, Bio C sealer revealed a decrease in cell confluence and several morphological changes. AH Plus and Bio MTA+ did not seem to affect the cell confluence however morphology alterations were observed. In the cytogenetic study, a severe decrease of the mitotic index and a large number of chromosomal aberrations were observed. The present study represents an advance in the understanding of the biocompatibility of AH Plus, Bio MTA+, and Bio C sealers. These sealers demonstrated some cytotoxicity, depending on the concentration used. Although more validation studies are still needed, this study brings very relevant results in terms of cytotoxicity, cell morphology, and cytogenetic alterations. Conclusions: These results could help in the selection of the most appropriate compounds to be used in clinical practice as well as to determine the maximum recommended amounts of each sealer. Clinical Relevance: This study highlights the potential cytotoxic effects of three commonly used root canal sealers on human gingival fibroblasts, with varying degrees of impact depending on the concentration used. The results emphasize the importance of careful consideration when selecting and applying these materials in clinical practice.

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.