TotalFill BC Research Articles

Influence of retreatment in the formation of dentinal microcracks in mandibular molars filled with a calcium silicate based sealer

Introduction: In endodontically treated teeth, dentinal defects such as microcracks can progress to a vertical root fracture and lead to tooth loss. Objective: The present study aimed to evaluate, by micro-computed tomography analysis, the formation of dentinal microcracks during filling removal in endodontic retreatment of root canals filled with gutta-percha and Total Fill BC bioceramic sealer. Methods: Twenty mesial roots of mandibular molars were instrumented and obturated with gutta-percha and Total Fill BC sealer and then the filling material was removed with rotary Protaper Retreatment files. The specimens were scanned before instrumentation, after filling and after retreatment. The transversal images obtained after filling were compared with the images obtained after removal of the filling material. A descriptive statistical analysis was performed. Results: Among the 24.444 cross-sections analyzed, 5.67% presented some type of dentinal defect, with 0.51% in the initial images, 2.58% in the post-filling images and 2.58% in the post-retreatment images. All the dentinal defects identified in the images obtained after the retreatment were already present in the corresponding images after the filling. New dentinal microcracks were not observed after removal of the filling material. Conclusion: Retreatment of mesial roots of mandibular molars filled with a silicate-based root canal filling material do not influence the formation of dentinal microcracks.

Retreatment of mesial roots of mandibular molars filled with resin- based and bioceramic sealers

Aim: The aim of this study was to evaluate, by micro-computed tomography (micro-CT) analysis, the remaining filling material during endodontic retreatment performed with Protaper retreatment without solvent. Methods: Forty mandibular molars were divided into two groups (n = 20) according to the sealer used in the obturation: the bioceramic TotalFill BC (TF) or the resin-based AH Plus (AHP). The specimens were scanned before instrumentation, after obturation and after filling removal. Only the mesial roots were analysed. The filling volumes and the remaining filling material were calculated in the entire root canal and in the cervical, middle and apical thirds. Results: The volume of obturation and the volume of remaining filling material in the entire root canal and in the cervical, middle and apical thirds of the canal between the groups were not statistically different (independent t-test, p > 0.05). In the AHP group, there was a higher percentage of remaining filling material in the middle third than in the cervical third (p < 0.05). Conclusion: The filling material could not be entirely removed from any specimen.

Physico-Chemical Investigation of Endodontic Sealers Exposed to Simulated Intracanal Heat Application: Hydraulic Calcium Silicate-Based Sealers.

The aim of this study was to gain information about the effect of thermal treatment of calcium silicate-based sealers. BioRoot RCS (BR), Total Fill BC Sealer (TFBC), and Total Fill BC Sealer HiFlow (TFHF) were exposed to thermal treatment at 37 °C, 47 °C, 57 °C, 67 °C, 77 °C, 87 °C and 97 °C for 30 s. Heat treatment at 97 °C was performed for 60 and 180 s to simulate inappropriate application of warm obturation techniques. Thereafter, specimens were cooled to 37 °C and physical properties (setting time/flow/film thickness according to ISO 6876) were evaluated. Chemical properties (Fourier-transform infrared spectroscopy) were assessed after incubation of the specimens in an incubator at 37 °C and 100% humidity for 8 weeks. Statistical analysis of physical properties was performed using the Kruskal-Wallis-Test (P = 0.05). The setting time, flow, and film thickness of TFBC and TFHF were not relevantly influenced by thermal treatment. Setting time of BR decreased slightly when temperature of heat application increased from 37 °C to 77 °C (P < 0.05). Further heat treatment of BR above 77 °C led to an immediate setting. FT-IR spectroscopy did not reveal any chemical changes for either sealers. Thermal treatment did not lead to any substantial chemical changes at all temperature levels, while physical properties of BR were compromised by heating. TFBC and TFHF can be considered suitable for warm obturation techniques.

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

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

Experimental research of retreatability of root canals filled with bioceramic sealer

Aim. This study aimed to determine the residual filling material and the reestablishment of working length and apical patency after retreatment of TotalFill® BC Sealer.Materials and methods. Thirty maxillary incisors were used in a single cone obturation technique with TotalFill BC Sealer (FKG, Switzerland) and randomly divided into 6 groups according to the retreatment technique. The samples were scanned by micro-CT before and after retreatment in order to evaluate the residual filling material on the root dentin walls. Data were analyzed statistically with the Kruskal-Wallis tests (p &lt; 0.05).Results. No instrumental protocol was able to remove all obturation material from the root canals. The differences in reduction in the total volume of filling material percentage were statistically significant (p &lt; 0.05) among groups with and without ultrasound or sound activation in retreatment protocol.Conclusions. The most effective root canal retreatment was determined with D-Race + XP-endo Shaper + XP-Endo Finisher R + US (3.0 W) protocol; it was found that the efficiency of filling material removal was more than 92%.

The effect of different sealer volume on bond strength of total fills BC obturating system

The bond strength of Total fill BC obturation system using single cone size 40 and size 50 at different time intervals; 1days and 7 days was evaluated in this vitro study. Twenty four single rooted single canal extracted human teeth were used in this study. All the teeth were instrumented with a crown down technique by Endo Star taper 4% to achieve size #50 apical preparation .irrigation was done using 10ml 2.25% Na(ocl), then 10ml of 17% EDTA and final rinse with 10ml sterile normal saline. Single cone technique was used for obturating all the groups as the manufacturer’s instructions .The samples were classified into two main groups according to the size of the obturating material (n=12); group “I” canals were obturated with Totalfill points size 50 and group “II” (canals were obturated with Totalfill points size 40. Each group was subdivided into 2 subgroups according to the time of the test (n=6); subgroup “1’ examined after 1 day and Subgroup “2” examined after 7 days. Each subgroup is tested using universal testing machine to evaluate the push out Bond strength. after 1 day; there was no statistically significant difference between the two groups, However After 7 days regardless of root level, the Group obturated with size 50 showed statistically significantly higher median push-out bond strength than Group obturated with size 40.it was concluded that The bond strength is higher with the large size of gutta percha core than the volume of sealer.

Rendgenkontrastnost jednokomponentnih kalcijum silikatnih endodontskih pasta

Background: Premixedcalcium silicate-based sealers are ready-to-use, injectable materials with advantageous biological properties that create environment favorable for periapical tissues repair and health. The aim of our study was to examine the radiopacities of premixed calcium silicate-based sealers:TotalFill BCSealer, EndoSequence BC Sealer, Ceraseal, Bio-C Sealer and to compare them with epoxy-basedsealer, AH Plus. Material and methods: Three specimens (2 mm thick and 5 mm in diameter) of each sealer were radiographed using charge-coupled device-baseddigital sensor (Trophy Radiology, Cedex, France) along with an aluminum stepwedge reference.For radiopacity determination, a graph of the logarithm of aluminum thickness versus radiographic density was plotted and a calibration curve was generated. Radiopacities were assessed from the graph and presented as millimeters of aluminum per millimeter of material (mmAl).ANOVA with a post hoc Tukey test was used for statistical analysis and significance was set at 0.05. Results: Radiopacity values of EndoSequence BC Sealer and Bio-C Sealerwere significantly lower than radiopacities of Ceraseal and AH Plus. Differences in values between EndoSequence BC Sealer and Bio-C Sealer as well as between Ceraseal and AH Plus were nonsignificant. TotalFill BC Sealer was nonsignificantly different from all other sealers. Conclusion: Premixed calcium silicate-based endodontic sealers evaluated in our study had radiopacity values higher than 9 mmAl, in ascending order,from Bio-C Sealer, EndoSequence BC Sealer, TotalFill BC Sealer to Ceraseal.

Calcium Silicate-Based Experimental Sealers: Physicochemical Properties Evaluation

The aim of this study was to evaluate physicochemical properties of calcium silicate-based experimental (CS) endodontic sealers, developed using two different vehicles: polyethylene glycol (PG) (CS-PG) or polyethylene glycol associated to chitosan hydrogel (CS-PGCH). TotalFill BC Sealer (TF) and AH Plus (AHP) were evaluated for comparison. Setting time, flow, radiopacity, pH, solubility and volumetric change were analyzed. Data were submitted to ANOVA and Tukey tests with 5% significance level. The CS-PGCH had significantly greater setting time. CS-PG flow was similar to AHP. CS-PG had higher radiopacity than CS-PGCH. Calcium silicate-based sealers presented alkaline pH in all periods. CS-PGCH presented higher solubility in comparison with CS-PG. The volumetric change of CS-PG was similar to TF after 7 days, and to AHP after 30 days. CS-PG presented proper setting time, radiopacity, flow and pH, besides low volumetric change, showing better results than CS-PGCH, and potential for clinical application.

Subcutaneous Implantation Assessment of New Calcium-Silicate Based Sealer for Warm Obturation.

Calcium silicate-based sealers were recently introduced as a new class of endodontic sealers, with potential further benefits due to their bioactivity. The aim of this study was to evaluate the biocompatibility of two new hydraulic calcium silicate-based sealers, TotalFill BC Sealer (FKG, La Chaux-des-Fonds, Switzerland) and TotalFill BC Sealer HiFlow (FKG, La Chaux-des-Fonds, Switzerland) through subcutaneous implantation in connective tissue of rats. Subcutaneous implantation was performed in 16 young Wistar rats. Four polyethylene tubes were implanted in each animal, one empty to serve as a control, and three filled with tested sealers: AH Plus as reference (Dentsply DeTrey, Konstanz, Germany), TotalFill BC Sealer (BC) and TotalFill BC Sealer HiFlow (HiFlow). Eight rats were euthanized at 8 days and the remaining eight at 30 days. Hematoxylin-eosin staining was used to score the inflammatory reaction, macrophage infiltrate and to measure the thickness of the fibrous capsule. von Kossa staining was performed to evaluate the mineralization level. Kruskal–Wallis test followed by Dunn’s post hoc test was used to analyze non-parametric data. To analyze the influence of the implantation time within each material, a Mann–Whitney U test was performed. At eight days post-implantation, AH Plus induced a more intense inflammatory reaction when compared both with the control (p 0.001) and BC (p 0.01). HiFlow presented a higher score of macrophage infiltrate than control (p 0.01) and BC (p 0.05). The fibrous capsule thickness in this period was significantly higher for the BC group when compared to control (p 0.01) and AH Plus (p 0.05). The mineralization potential was higher for the HiFlow group when compared with the control (p 0.001) and AH Plus (p 0.001). At 30 days post-implantation, the score for the inflammatory reaction remained higher for the AH Plus group when compared both to control (p 0.01) and BC (p 0.001). The macrophage infiltrate of the HiFlow was significantly higher than control (p 0.001) and AH Plus groups (p 0.01), additionally, the fibrous capsule of the BC (p 0.001) and HiFlow (p 0.01) groups were both thicker than control. Mineralization potential was observed only on BC (p 0.05) and HiFlow groups (p 0.001), when compared to control). BC exhibited the best biocompatibility performance of all tested sealers and HiFlow provided the greatest induction of mineralized tissues. Both TotalFill BC Sealer and TotalFill BC Sealer HiFlow are biocompatible and show potential bioactivity when implanted in the subcutaneous tissue. Bioactivity was not found in AH Plus.

The effect of calcium hydroxide on the apical microleakage of canals filled with bioceramic and resin sealers

Aim: To evaluate the impact of calcium hydroxide (Ca[OH]2) on the apical microleakage of canals filled with the bioceramic Total Fill BC (TF BC) and the resin AH 26 sealers. Methodology:A total of 104 human single-canal maxillary teeth were prepared with rotary files. The teeth were randomly divided into two main test groups (n=48) and two control groups, one positive and one negative (n=4). In one test group, Ca(OH)2 was used; in the other test group, no dressing was placed within the canal. Samples in each test group - with or without Ca(OH)2 dressing - were randomly divided into two subgroups. In one subgroup, AH 26 sealer was used and in the other one, TF BC sealer was used. The specimens with Ca(OH)2 were kept at 37 °C in 100% humidity. A dye penetration technique was used to evaluate the leakage. The data were analyzed by Kolmogorov-Smirnov, Kruskal-Wallis, Mann-Whitney U, and Fisher exact tests. Results: The mean microleakage in the subgroups filled with TF BC sealer, with or without Ca(OH)2, was significantly greater than that in the subgroups filled with AH 26 sealer. In addition, the microleakage of the TF BC specimens with Ca(OH2) was significantly higher than the microleakage of TF BC specimens without the dressing (P<0.001). Conclusion: The findings of this study showed that use of Ca(OH)2 as an intracanal dressing negatively affected the sealing potential of TF BC.

Postobturation Pain Associated with Tricalcium Silicate and Resin-based Sealer Techniques: A Randomized Clinical Trial

IntroductionThe incidence of immediate postobturation pain associated with 2 sealer techniques was compared and potential prognostic factors identified. MethodsPatients referred for endodontic treatment were recruited with informed consent. Root canals were debrided and teeth rendered asymptomatic before random allocation to receive TotalFill BC (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) or AH Plus sealer (Dentsply Maillefer, Ballaigues, Switzerland). Patients blinded to the sealer reported their postobturation pain experience 1, 3, and 7 days after treatment. Blinded and calibrated assessors independently reviewed treatment quality, sealer extrusion, and radiographic data under standardized conditions. ResultsOne hundred sixty eligible patients (163 teeth, 95.3%) returned their pain diary. No postobturation pain difference was found between the 2 sealers (P > .05), although the AH Plus sealer technique was significantly associated with extrusion beyond the apex (P < .05; odds ratio [OR] = 3.02; 95% confidence interval [CI], 1.39–6.57). Thirty-three (20.6%) patients reported pain on day 1 (median 1 = very mild pain), 16 (10.0%) on day 3 (median 1 = very mild pain), and 9 (5.6%) on day 7 (median 2 = mild pain). The prognostic factors were as follows:(1) moderate/severe preoperative pain (OR = 4.41; 95% CI, 1.42–13.76 on day 3 and OR = 5.16; 95% CI, 1.17–22.78 on day 7),(2) provoked preoperative pain (OR = 4.24; 95% CI, 1.40–12.78 on day 3 and OR = 5.35; 95% CI, 1.27–22.51 on day 7),(3) pulpless tooth (OR = 0.11; 95% CI, 0.02–0.57 on day 3), and(4) sonic activation during treatment (OR = 3.02; 95% CI, 1.39–6.57 on day 1 and OR = 3.01; 95% CI, 1.05–8.59 on day 3). ConclusionsThere was no significant difference in pain experience between teeth filled using AH Plus or TotalFill BC Sealer 1, 3, and 7 days after obturation. Patient- and treatment-related factors could influence postobturation pain.

Effect of restorative timing on shear bond strength of composite resin/calcium silicate-based cements adhesive interfaces.

The aim of this study was to evaluate the shear bond strength inherent to immediate and delayed definitive composite resin restorations, over three different biomaterials. Fifty-four aluminum blocks were randomly assigned to six experimental groups(n = 9) according to the biomaterial (Biodentine, TotalFill BC Putty, or PCM) and restoration timing (immediate or 7 days delayed). Regarding the restorative procedures, a two-step self-etch bonding system (Clearfil SE Bond) was applied and subsequently restored using a flowable composite resin (SDR). After shear bond strength testing, fracture pattern analysis was performed. The significance level was set at α = 0.05. Within the immediate groups, Biodentine showed the highest mean shear bond strength value, with no statistically significant differences (P > 0.05) being detected when compared with both TotalFill (P = 0.072) and PCM (P = 0.232) groups. Regarding the delayed restoration groups, Biodentine and TotalFill presented the highest mean shear bond strength value, with statistical differences when compared with PCM (P = 0.002 and P = 0.043, respectively). No statistically significant differences (P > 0.05) were verified between both immediate and delayed groups for each tested biomaterial. Also, a statistically significant association was found between the fracture type and the biomaterial (P < 0.001). Our findings suggest that all tested biomaterials present suitable alternatives which allow to perform restorative procedures immediately after pulp capping biomaterial placement (3 or 12 min, depending on the bioactive cement), therefore requiring one single appointment to complete the procedure. Biodentine and TotalFill BC Putty have shown superior shear bond strength results when compared with PCM, within a delayed timeframe (7 days).

Evaluation of the biological properties of two experimental calcium silicate sealers: an in vivo study in rats.

To evaluate the biological properties of experimental sealers based on tricalcium silicate and dicalcium silicate, manipulated with polyethylene glycol (CE-1) and with the addition of calcium hypochlorite (CE-2) compared to AH Plus (AHP) and TotalFill BC Sealer (TBC). The tissue reaction caused by the materials in the subcutaneous tissue of rats was evaluated after implantation of polyethylene tubes filled with the materials at 7, 15, 30 and 60days. Sections were stained with haematoxylin and eosin (HE) for morphological analysis and to evaluated number of inflammatory cells/mm2 (ICs). Sections were used for immunohistochemical detection of interleukin-6 (IL-6) and osteocalcin (OC). The von Kossa method was used to identify calcium precipitation in the capsules. The data were submitted to anova and Tukey's tests, with 5% significance level. At 7days, CE-1, CE-2 and AHP had higher numbers of ICs. AHP presented higher immunolabelling for IL-6. After 15days, regarding IL-6, there was no difference between CE-2 and the control group. At 30days, AHP exhibited the highest number of IC (P<0.05) and CE-2 and the control group presented the lowest ICs and IL-6-positive cells. After 60days, all materials exhibited decreases in ICs. CE-2, TBC and the control had the lowest values (P<0.05). No significant difference was detected between CE-1 and TBC, and between CE-2 and control considering the immunoexpression of IL-6. In this period, AHP had the greatest number of IC and IL-6 (P<0.05). In all periods, CE-1, CE-2 and TBC sealers had von Kossa-positive structures and OC-immunolabelled cells. CE-2 had higher number of OC-positive cells than the CE-1 and TBC sealers (P<0.05), in all periods. OC immunolabelling was not observed in the capsules of AH Plus and the control groups. The experimental sealer and its association with calcium hypochlorite, in addition to TotalFill BC Sealer, were biocompatible and had bioactive potential.

Antimicrobial Effectiveness of Calcium Silicate Sealers against a Nutrient-Stressed Multispecies Biofilm.

Purpose: This study compared the antimicrobial efficacy of calcium silicate sealers (BioRoot RCS and Total Fill BC) and conventional sealers (AH Plus and Tubli-seal) against planktonic bacteria and a nutrient-stressed multispecies biofilm. Methods: Antimicrobial properties of freshly mixed sealers were investigated using the direct contact test (DCT) and a nutrient-stressed multispecies biofilm comprised of five endodontic strains. Antimicrobial activity was determined using quantitative viable counts and confocal laser scanning microscopy (CLSM) analysis with live/dead staining. The pH of the sealers was analysed over a period of 28 days in Hanks Balanced Salt Solution (HBSS). Analysis of variance (ANOVA) with Tukey tests and the Kruskal–Wallis test were used for data analysis with a significance of 5%. Results: All endodontic sealers exhibited significant antimicrobial activity against planktonic bacteria (p < 0.05). BioRoot RCS caused a significant reduction in viable counts of the biofilms compared to AH Plus and the control (p < 0.05), while no significant difference could be observed compared to TotalFill BC and Tubli-seal (p > 0.05). CLSM analysis showed that BioRoot RCS and TotalFill BC exhibited significant biofilm inhibition compared to Tubli-seal, AH Plus and the control (p < 0.05). BioRoot RCS presented with the highest microbial killing, followed by TotalFill BC and Tubli-seal. Alkalizing activity was seen from the onset by BioRoot RCS, TotalFill BC and AH Plus. After 28 days, BioRoot RCS demonstrated the highest pH in HBSS (pH > 12). Conclusions: Calcium silicate sealers exhibited effective antimicrobial properties. This was demonstrated by superior biofilm inhibition capacity and microbial killing, with strong alkalizing activity compared to epoxy-based and zinc oxide-eugenol-based sealers.

Tooth Discoloration after Regenerative Endodontic Procedures with Calcium Silicate-Based Cements—An Ex Vivo Study

The aim of the present ex vivo study was to assess and compare coronal discoloration induced by four endodontic biomaterials used in regenerative endodontic procedures (REPs). Root resection was executed horizontally, 2 mm apical to the cementoenamel junction, in all fifty-four teeth. After accessing the pulp chamber, specimens were randomly divided in groups and filled with either saline solution or blood, followed by calcium silicate-based cements (CSCs) placement: ProRoot mineral trioxide aggregate (MTA) (Dentsply Sirona), Biodentine (Septodont), TotalFill BC (FKG), or pulp capping material (PCM) (Coltène). Color change (ΔE) was assessed using the L* a* b* system at five different timepoints (before and immediately after biomaterial application, 72 h, 7 days, and 6 months). The significance level for statistical analysis was set at p &lt; 0.05. There are statistically significant differences regarding ΔE over time (p &lt; 0.001). Statistical differences are found considering material (p &lt; 0.001), treatment (p = 0.007), or both (p = 0.002). If solely the material or treatment is considered, regardless of time, statistically significant differences are detected (p &lt; 0.001). After a six-month period of evaluation, blood exposure might be a critical factor in biomaterials’ color variation. Biodentine presents the lowest discoloration potential, followed by TotalFill and PCM, albeit without statistically significant differences. MTA exhibited the greatest color variation. The selection of biomaterial should consider the material’s discoloration potential.

Determining the setting of root canal sealers using an in vivo animal experimental model.

To present and explore the potential of an animal-based experimental model developed to determine the set of root canal sealers in vivo. The setting of AH Plus, BioC Sealer, TotalFill BC Sealer, and Sealapex was determined using either ISO 6876 or the novel in vivo method proposed in this study. The in vitro setting time of the sealers tested was determined in accordance with ISO 6876:2012. In determining the in vivo set, 24 adult Wistar rats were followed up for two evaluation periods: 1 and 4 weeks. Their upper-right incisor was extracted, and its pulp tissue was removed. The root canal was then filled from retrograde with one of the 4 sealers, and the tooth was re-implanted and fixed with a layer of a flowable composite resin. After 1 or 4 weeks of the surgical procedures, the animals were euthanized, and their incisors were extracted. Two-mm-thick slices of the middle third of the tooth root were obtained and assessed with a Gillmore device, to determine whether or not the sealer had set. The following in vitro results were obtained by using ISO 6876 methodology: AH Plus set after a mean time of 423 ± 20 min and 476 ± 35 min, in metal and plaster molds, respectively. BioC Sealer set after 7 days (in dental plaster molds), whereas TotalFill BC Sealer and Sealapex did not set even after 25 days in both tested conditions (metal or dental plaster molds). Using the novel in vivo methodology, AH Plus, BioC Sealer, and TotalFill BC Sealer set after both 7 and 30 days. In contrast, Sealapex did not set at either time point. AH Plus and BioC Sealer set under both in vitro and in vivo test conditions. TotalFill BC Sealer did not set under in vitro conditions but did after 1 week under in vivo conditions. Sealapex did not set under either in vitro or in vivo conditions. The influence of the testing conditions on the setting results is a clear indication that new in vivo experimental models should be useful in future studies on Bioceramics root canal sealers.

Influence of Powder-to-Gel Ratio on Physicochemical Properties of a Calcium Silicate Sealer

Differences in liquid-to-powder ratio can affect the properties of calcium silicate-based materials. This study assessed the influence of powder-to-gel ratio on physicochemical properties of NeoMTA Plus. Setting time (minutes), flow (mm and mm²), pH (at different periods), radiopacity (mm Al) and solubility (% mass loss) were evaluated using the consistencies for root repair material (NMTAP-RP; 3 scoops of powder to 2 drops of gel) and root canal sealer (NMTAP-SE; 3 scoops of powder to 3 drops of gel), in comparison to Biodentine cement (BIO) and TotalFill BC sealer (TFBC). Statistical analysis was performed using one-way ANOVA and Tukey tests (α=0.05). BIO had the shortest setting time, followed by NMTAP-RP and NMTAP-SE. TFBC showed the highest setting time and radiopacity. BIO, NMTAP-RP, and NMTAP-SE had similar radiopacity. All materials promoted an alkaline pH. NMTAP-RP/SE presented lower solubility than BIO and TFBC. Regarding the flow, TFBC had the highest values, followed by NMTAP-SE, and NMTAP-RP. BIO had the lowest flow. In conclusion, NMTAP in both powder-to-gel ratios showed high pH and low solubility. The increase in the powder ratio decreased the setting time and flow. These findings are important regarding the proper consistency and work time to clinical application.

Characterization of heat resistant hydraulic sealer for warm vertical obturation

ObjectiveWarm vertical compaction of gutta-percha is a technique that is used by most specialists for root canal obturation. The sealers currently available exhibit irriversible chemical changes when heated. New biologically active sealers that do not sustain irreversible changes when heated are an attractive alternative to be used with warm vertical compaction obturation technique. The aim of this study was to measure the heat generated by warm vertical compactors inside the root canal, characterize a newly developed root canal sealer at different temperatures and verify its suitability at the actual temperature window used clinically. MethodsThe typical temperatures generated by two heat carriers in a root canal were assessed by thermocouples. Two premixed root canal sealers TotalFill BC and HiFlow BC (FKG, Switzerland) were allowed to set and they were characterized by scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS) and X-ray diffraction analysis (XRD) immediately after setting and by XRD after 28 days in physiological solution. The ion leaching in solution was assessed by inductively coupled plasma (ICP). The organic component was extracted in acetone and assessed by Fourier transform infrared spectroscopy (FT-IR) for both the unset sealer and sealer subjected to different temperatures. The heat profiles of both sealers were investigated by FT-IR and thermographic analysis. ResultsNone of the devices tested achieved the temperatures set on the dial. The highest temperatures were coronal followed by apical for both devices. The sealers were identical except for the vehicle. The inorganic components included tricalcium silicate, dicalcium silicate and zirconium oxide. No calcium hydroxide was produced by any of the sealers after immersion in physiological solution but calcium was released in solution. The chemistry of both sealers was modified when heated but both recovered when cooled. SignificanceThe heat carriers were unreliable and the heat generated inside the canal was not the same as the temperature set on the dial. Since both sealers had identical chemistry save for minimal modifications to the organic component and were both resistant to heat, TotalFill BC sealer is recommended for use with warm vertical compaction technique as it is cheaper and as effective as the HiFlow.

Retreatment efficacy of hydraulic calcium silicate sealers used in single cone obturation

ObjectiveRemoval of obturating materials from the root canal during retreatment is usually accomplished by mechanical means and organic solvents to dissolve the gutta-percha. This strategy is ineffective on sealers. The aim of this research was to assess the efficacy of mechanical instrumentation aided by targeted chemical means for removal of hydraulic sealers. MethodsA preliminary study assessed the effect of 17% EDTA and 10/20% formic acid applied for 5 or 10 min on dentine and for 5 min on Totalfill BC sealer (FKG). Microhardness and structural integrity by scanning electron microscopy and energy dispersive spectroscopy were investigated. The optimal solutions were used as adjuncts to mechanical instrumentation to remove obturations made with single cone using a standard gutta-percha and bioceramic coated gutta-percha and Totalfill BC sealer. The removal of obturation material from the root canal system of obturated teeth was evaluated using microcomputed tomography. The canal patency and reestablishment of working length were also checked. ResultsThe preliminary study showed that 17% EDTA and 10% formic acid applied for 5 min did not damage the dentine but effected the structural integrity of the sealer. 10% formic acid used in conjunction with mechanical instrumentation was the most efficient method to remove the obturation material from the root canal, achieving over 95% removal for both gutta-percha and the bioceramic coated version and also achieve patency and reestablishment of working length. ConclusionsThe use of a targeted irrigation protocol with a chemical adjunct to the mechanical instrumentation is the best way to retreat teeth obturated with hydraulic calcium silicate sealer and gutta-percha.

Short-Term Antibacterial Efficacy of Three Bioceramic Root Canal Sealers Against Enterococcus Faecalis Biofilms.

ObjectivesThe aim of the study was to evaluate the antimicrobial efficacy of three bioceramic root canal sealers against Enterococcus faecalis (E. faecalis) biofilm.Material and methodsE. faecalis bacterial suspension was grown on filter paper discs on agar plates. After the incubation period, the discs were covered with four different root canal sealers: 1) Premixing bioceramic root canal sealer (TotalFill BC Sealer); 2) Dual component bioceramic sealer (BioRoot RCS); 3) Mineral trioxide agreggate based sealer (MTA Fillapex); 4) Epoxy resin-based selar (AH Plus). After contact time of 60 minutes, the sealers were removed, and the discs were transferred into sterile tubes containing phosphate buffered saline. After serial dilutions, the aliquots of the suspension were cultivated for 24 hours. After the incubation period, the colony forming units (CFUs) were counted.ResultsThere were no significant differences in antibacterial efficacy between the Total Fill BC Sealer and the AH Plus sealer (p=0.386). Both sealers showed better antibacterial efficacy compared to the BioRoot RCS and the MTA Fillapex (p<0.001).ConclusionThe Total Fill BC Sealer and AH Plus had better antibacterial efficacy than the BioRoot RCS and the MTA Fillapex sealers.