Zinc Oxide-eugenol Research Articles

A randomized clinical trial comparing retention of complete dentures and oral health quality of life of patients with conventional and bioelectric impressions.

The aim of the present study was to comparatively evaluate the retention of complete dentures and oral health-related quality of life (OHRQoL) of patients with conventional and bioelectric impressions or transcutaneous electric nerve stimulation (TENS). A total of thirty (n=30) completely edentulous patients were randomly distributed into two groups: Group-C (n=15) (Conventional) and Group-T (n=15) (bioelectric). In Group C, border molding was performed using the manual manipulation of borders, and the final impression was made using zinc-oxide eugenol. In Group T, border molding and final impression were performed with the TENS application. Dentures were fabricated, and retention was evaluated with a digital gauge. OHRQoL was assessed at insertion and after three months of follow-up using the Oral Health Impact Profile Edentulous in Hindi (OHIP-Edent-H) questionnaire. A two-way ANOVA test was used for the significance level (P<0.05). Student t-test was used for intergroup comparison, and paired t-test was used for intragroup comparison of OHRQoL. There was no significant difference in the retention of maxillary and mandibular dentures fabricated with both techniques (P=0.283, P=0.682). Although, OHRQoL increased significantly in both groups at follow-up (P=0.001). However, at follow-up, the Functional Limitation (FL) domain was significantly better in the conventional group. Although, there was no significant difference in retention and OHRQoL between both groups. However, more clinical trials with large samples and longer follow-ups are required to reach a conclusive result.

Assessing the Role of Calcium Silicate-Based Sealers in Reducing Post-Treatment Microleakage

Calcium silicate-based sealers have emerged as a transformative innovation in endodontics, offering solutions to longstanding challenges such as microleakage, biocompatibility, and durability. These sealers demonstrate exceptional adaptability due to their hydraulic setting properties, ensuring tight seals in moist environments and reducing micro-gaps commonly associated with traditional materials. Their bioactivity, characterized by the release of calcium ions and hydroxyapatite formation, promotes periapical tissue healing and enhances the interface between dentin and the sealer, contributing to long-term treatment success. High alkalinity during setting provides sustained antimicrobial activity, effectively inhibiting bacterial proliferation within the root canal system. This property, coupled with low solubility and resistance to degradation, ensures stability and reliability even under challenging clinical conditions. Comparative studies reveal that calcium silicate-based sealers outperform traditional alternatives, such as epoxy resin and zinc oxide-eugenol sealers, in key performance metrics, including sealing ability, biocompatibility, and post-treatment outcomes. Clinically, these sealers are compatible with various obturation techniques, simplifying application while maintaining efficacy in sealing complex canal anatomies. Patients treated with calcium silicate-based sealers report lower incidences of postoperative pain, attributed to their anti-inflammatory properties and enhanced healing potential. Emerging research continues to refine their formulations, addressing limitations like prolonged setting times and optimizing handling properties. The integration of calcium silicate-based sealers into routine endodontic practice signifies a paradigm shift, driven by their ability to improve clinical outcomes and reduce failure rates. As material advancements progress, these sealers hold promises for broader applications in complex cases, further enhancing the predictability and success of root canal treatments. Their superior performance establishes them as a cornerstone in modern endodontic care, addressing both current and future challenges in the field.

Antimicrobial effect of bioceramic sealer in necrotic primary molars

BackgroundPulpally infected primary teeth should be retained until exfoliation whenever possible, as deciduous teeth are ideal space maintainers. Removing bacteria from the root canal is essential for a successful root canal treatment. Therefore, the present study compared the antimicrobial effects of resorbable bioceramic sealer with pastes of calcium hydroxide and iodoform mixed with zinc oxide and zinc oxide eugenol when used as intracanal medication on microorganisms of necrotic primary molars. The materials used in the study were: Paste A: Non-setting calcium hydroxide paste mixed with iodoform, Paste B: Zinc oxide eugenol, Paste C: Metapex with zinc oxide, Paste D: Metapex with zinc oxide eugenol, Paste E: Bio-C Pulpecto. Polymicrobial growth inhibition zone diameters around each of the five pastes were measured in mm to determine antimicrobial activity. The collected data were presented, tabulated, and statistically analyzed.ResultsComparison among all groups demonstrated a significant difference between them (P < 0.0001) using the Kruskal–Wallis test. Furthermore, Dunn's multiple comparisons test revealed that: Paste C (0.93 ± 3.55) and Paste A (2.13 ± 2.67) exhibited significantly the lowest antibacterial activity with no significant difference between them. Subsequently, Paste D (5.2 ± 5.89) and Paste E (8.73 ± 1.36) displayed no significant difference between them. In contrast, Paste B (11.8 ± 1.58) demonstrated significantly the highest antibacterial activity.ConclusionsBioceramic sealers could be utilized as filling material for root canal in primary molars because of their antimicrobial and biological properties.

A 4-year follow-up of root canal obturation using a calciumsilicate-based sealer and a zinc oxide-eugenol sealer: Arandomized clinical trial.

This randomized clinical trial assessed the outcomes of nonsurgical root canal treatment (RCT), comparing a calcium silicate-based sealer (CSBS) with the single-cone technique (SC) with a zinc oxide-eugenol (ZOE) sealer and warm vertical compaction (WVC). Ninety-two single- and multi-rooted teeth were divided into two groups and treated using either the SC with BioRoot™ RCS (BIO) or WVC with Pulp Canal Sealer™ EWT (PCS). Teeth with apical periodontitis (AP) in both groups were further divided into BIOAP and PCSAP subgroups. Standardized instrumentation and disinfection protocols were followed. Periapical index (PAI) was recorded, and clinical and radiographic follow-ups were conducted at 1, 3, 6, 12, 24, and 48 months. Outcomes considered included success rate (under strict and loose criteria), extraction, length of filling, voids, and extrusion rate, as well as changes in PAI score from baseline. Outcome variables and prognostic factors were analysed using binary and multiple logistic regression at p < .05. Sixty-seven teeth were included (recall rate, 73%). At 4-year follow-up, the overall success rates (BIO + PCS) were 89.6% by loose criteria and 83.3% by strict criteria. Subgroup success rates (BIOAP+PCSAP) were 88.5% by loose criteria and 80.4% by strict criteria. There were no significant differences between the groups in terms of success rate, extraction rate, length of filling, voids, or extrusion (p > .05). The pattern of PAI reduction was similar in both groups (p = .806). Treatment using the SC-CSBS technique and the ZOE sealer with the WVC technique demonstrated a similar success rate.

Clinical and Radiographic Evaluation of Zinc Oxide-ozonated Oil, Zinc Oxide-eugenol, Antioxidant Mix, and Probiotic Mix as Obturating Materials in Primary Teeth: An In Vivo Study.

The best space maintainer in both primary and mixed dentition is the primary tooth itself. This is not only because of the clinical crown but also due to the presence of the roots and periodontium that guide the eruption of the permanent tooth. Although over the years many materials have been tried for obturation of pulpectomized primary teeth, no material has been found to fulfill all requirements. The aim of the present study was to evaluate the clinical and radiographic efficiency of zinc oxide-eugenol (ZOE), zinc oxide-ozonated oil, antioxidant mix, and probiotic mix in root canal treatment of primary molars. One hundred twenty primary molars of children aged 4-9 years presenting to the department were randomly assigned to one of four groups: obturated with ZOE, zinc oxide-ozonated oil, probiotic mix, or antioxidant mix. All the pulpectomies were carried out by a single operator. Follow-up was done at 3, 6, 9, and 12 months, and treatment success or failure was determined by the evaluation of clinical and radiographic findings. There was a statistically significant difference with respect to postoperative pain and swelling among the four groups at the end of the 12-month follow-up period (p < 0.05). The study concludes that among the four different obturating materials, zinc oxide-ozonated oil has shown the most promising results in primary endodontically treated teeth, whereas antioxidant mix was comparable to ZOE with fewer disadvantages and side effects. Arora P, Mathur S, Arora P. Clinical and Radiographic Evaluation of Zinc Oxide-ozonated Oil, Zinc Oxide-eugenol, Antioxidant Mix, and Probiotic Mix as Obturating Materials in Primary Teeth: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(10):1153-1162.

Clinical Success of Pulpotomies Using Intermediate Restorations and Preformed Metal Crowns in the Context of a Developing Country: A Retrospective Questionnaire-Based Investigation.

Background: Dental caries is one of the most prevalent dental illnesses in children. Untreated severe caries can damage teeth, requiring pulpotomy to save them. Objective: To evaluate the clinical success rate of treatments involving pulpotomies + IRM (Intermediate Restorative Material, composed of reinforced zinc oxide-eugenol polymers) + preformed metal crowns (PMCs) in primary teeth of children treated at a public university in Mexico. Materials and Methods: A cross-sectional ambispective study was conducted on children aged 10 years or younger, treated at a public university in Mexico. A total of 1281 medical records from February 2018 to June 2023 were reviewed, yielding a sample of 199 children treated with pulpotomy + IRM + PMC. Information was collected via telephone interviews with parents/caregivers to inquire about any symptoms following the pulpotomy and metal crown treatments. Success was defined as the absence of pain, inflammation, or infection. Results: During the study period, the number of teeth treated with pulpotomy + IRM + PMC was 414, with follow-ups ranging from 6 to 69 months. Most participants were girls (54.3%), while 45.7% were boys. Out of the 167 pulpotomy + IRM + PMC treatments included in the study, the clinical success rate was 98.2%. Conclusions: The clinical success rate of primary teeth treated with pulpotomy + IRM + PMCs was high, close to 100%, based on evidence and symptom reports from parents/caregivers. It would be beneficial to implement its use in public health institutions in countries such as Mexico.

Clinical Outcome Evaluation of The Effectiveness of Calcium Hydroxide as A Root Canal Sealer Constituent

Background: The objective of this study was to evaluate the clinical outcomes of using calcium hydroxide-containing sealer (Sealapex) compared to zinc oxide eugenol (ZOE) sealer in single-visit root canal treatments.Methods: This cross-sectional observational study was conducted at different private clinics, Dhaka, Bangladesh during the period from January 2018 to December 2018. A total of 60 permanent teeth with periradicular pathosis were selected and randomly assigned into two groups. Group 1 (ZOE group) comprised 30 teeth treated with a ZOE sealer, while Group 2 (Sealapex group) included 30 teeth treated with a calcium hydroxide-containing sealer. Clinical evaluations were performed at 3 months and 12 months post-treatment, with patient complaints recorded and analyzed using SPSS version 22 and Microsoft Excel.Results: Group 2 had a higher proportion of younger participants (40.00% aged 11-20) compared to Group 1 (26.67%). Group 1 had more males (66.67%) compared to Group 2 (56.67%). Trauma was the leading etiological factor in both groups. Maxillary teeth were more frequently affected, with 56.67% in Group 1 and 63.33% in Group 2. Pre-operative pain was higher in Group 2 (90.00%) compared to Group 1 (76.67%). At the 3-month follow-up, percussion pain was more prevalent in Group 1 (76.67%) than in Group 2 (46.67%, p = 0.016). By the 12-month follow-up, percussion pain persisted in 13.33% of Group 1 but was absent in Group 2. Group 2 achieved a 100.00% success rate, significantly higher than Group 1’s 86.67% (p = 0.038).Conclusion: The use of calcium hydroxide-containing sealer (Sealapex) in single-visit root canal treatments resulted in superior clinical outcomes compared to zinc oxide eugenol sealer. These findings suggest that calcium hydroxide-containing sealers offer better pain management and higher long-term success rates, making them a more effective alternative for endodontic treatments. Further research is recommended to confirm these results in broader clinical settings.

Radiological Outcome of Calcium Hydroxide as A Root Canal Sealer Constituent

Background: The effectiveness of root canal sealers plays a crucial role in the success of endodontic treatments by preventing microbial leakage and promoting periapical healing. This study aimed to compare the radiological outcomes of calcium hydroxide-based sealers and zinc oxide eugenol sealers in treating teeth with periradicular pathosis.Methods: This cross-sectional observational study was conducted at different private clinics, Dhaka, Bangladesh during the period from January 2019 to December 2019. A total of 60 permanent teeth with periradicular pathosis were randomly assigned into two groups: Group 1 (n=30), treated with zinc oxide eugenol sealer, and Group 2 (n=30), treated with calcium hydroxide-based sealer. Clinical evaluations were conducted on days 2 and 7 post-treatment, and radiological evaluations were performed at 3, 6, and 12 months. Data were analyzed using SPSS version 22.Results: The majority of participants were aged 11-30 years, with a higher proportion of males in both groups. Trauma was the leading etiological factor, with maxillary teeth being more frequently affected. Group 2 showed significantly better radiological outcomes, with 80.00% exhibiting reduced periapical pathosis size at 3 months, compared to 26.67% in Group 1 (p &lt; 0.001). At 6 months, 93.33% of Group 2 showed reduced pathosis size, compared to 60.00% in Group 1 (p = 0.002). At 12 months, 96.67% of Group 2 and 83.33% of Group 1 showed reduced pathosis size (p = 0.194). The final success rate was 96.67% in Group 2 and 86.67% in Group 1, with no statistically significant difference (p = 0.353).Conclusion: Calcium hydroxide-based sealers provide superior radiological outcomes compared to zinc oxide eugenol sealers in the treatment of teeth with periradicular pathosis. These findings support the use of calcium hydroxide sealers for enhanced endodontic treatment outcomes.

Assessment the bioactivity of zinc oxid eugenol sealer after the addition of different concentrations of nano hydroxyapatite-tyrosine amino acid

Aim: Zinc oxide eugenol sealer has been used till now in endodontic obturation. However, despite many improvements in its formula, it still does not have, the essential root canal sealer’s properties which is the apatite forming ability. The aim of the present study is to assess the effect of the incorporation of nano Hydroxyapatite- tyrosine amino acid at different concentrations in the zinc oxide eugenol sealer formula in terms of bioactivity analysis. Methods: The nano hydroxy apatite-tyrosine amino acid was incorporated into the original zinc oxide eugenol (endosell) at different concentrations starting from (10 – 20)%. The chemical changes in zinc oxide eugenol before and after addition were characterized using FTIR and XRD. The setting time test was done according to ADA specification no. 57. The bioactivity analysis for the zinc oxide eugenol before and after the addition was evaluated according to ISO/FDIS 23317:2007(E) by using 28 days of storage in phosphate buffer saline, and then the hydroxyapatite precipitation and Ca/P ratio was evaluated using FESEM/EDX. Results: The FTIR and XRD confirmed the setting reaction occurrence among the (original ZOE, nHAP, and Tyr). The XRD and FESEM/EDX analyses confirmed the HAP precipitation on the ZOE sample surfaces after the addition of (nHAP-Tyr a.a) and this precipitation was increased with increased concentrations of additions. Conclusion: Incorporated (20) % of equal amounts of “nHA-Tyr a.a” can convert the ZOE to bioactive sealer as confirmed by XRD and FESEM/EDX. However, other characteristic analyses like Nuclear magnetic resonance, atomic force microscopy, and in vivo animal study were needed to further confirm the results.

Comparison of conventional and digital impression approaches for edentulous maxilla: clinical study

BackgroundThe expectations for the clinical and laboratory phases of tissue-supported complete dentures (TSCDs) are changing. Currently, there is a trend towards fast, comfortable, reliable, and low-cost methods. In TSCD impressions, simplified impression and digital impression methods involving the use of an intraoral scanner (IOS) are becoming preferable. Given this situation, this study aims to compare different conventional and digital impression methods used in TSCDs.MethodsPatients with maxillary complete edentulism and healthy oral mucosa were included in this study. In the digital group, two different impressions were made using an IOS (Trios4) without (D1) and with (D2) artificial intelligence scanning (AI-Scan). In addition, a modified impression (D3) was made using the IOS in two steps, including the occlusal rim. In the conventional group, a two-step impression (C1) using an individual tray with zinc oxide eugenol and a one-step simplified impression (C2) using a stock tray with irreversible hydrocolloid were made. The comparison groups were determined to be C1-C2, C1-D1, D1-D2, and D1-D3. The best-fit algorithm was used to superimpose the impressions to be compared. The right and left vestibular areas, postdam area, palatal area, right and left matching area, entire surface, and borders were evaluated separately.ResultsFifteen patients were included in this study. In the C1-C2 group, the mean deviation at the borders was statistically significant (p = 0.01). No regions in the C1-D1 and D1-D3 groups exhibited significant differences in the mean amount of deviation (p > 0,05). In the D1-D2 group, the mean deviation in the palatal area was significant (p = 0,03).ConclusionIn maxillary edentulism, digital impressions have shown comparable results to conventional impressions, suggesting promising implications for clinical applications.Trial RegistrationThe clinical trial has been registered (ClinicalTrials.gov ID NCT06400277, registration date 06/05/2024, ‘retrospectively registered’).

Comparative Evaluation of Microleakage of Zinc Oxide Eugenol and Endoflas as Obturating Materials Using Different Root Canal Irrigants in Primary Teeth: An In Vitro Study.

The aim of this study was to evaluate and compare the apical microleakage of zinc oxide (ZOE) eugenol and Endoflas as obturating materials using different root canal irrigants in primary teeth. A total of 80 extracted primary anterior teeth were divided randomly into four groups with different irrigants and obturating materials used. Group I [ZOE + sodium hypochlorite (NaOCl)], group II [ZOE + NaOCI + ethylenediaminetetraacetic acid (EDTA)], group III (Endoflas FS + NaOCI), group IV (Endoflas FS + NaOCI + EDTA). Cleaning and shaping of the root canals were done using specified irrigants, followed by obturation with ZOE eugenol and Endoflas as per the respective groups. Specimens were then immersed in 2% methylene blue dye solution and stored for 24 hours. The specimens were split longitudinally into two halves and observed under a stereomicroscope. Apical microleakage was measured from the apex to the most coronal extent of dye penetration. The highest dye penetration was recorded for teeth filled with ZOE, group I (ZOE + NaOCl), with mean values of 1.924 ± 0.925. Endoflas group IV (Endoflas + NaOCI + EDTA) showed the lowest dye penetration with mean values of 0.901 ± 0.255. There was a statistically significant difference between the ZOE and Endoflas groups (p < 0.001). The result showed a statistically nonsignificant difference between the two Endoflas groups (p = 1.000). Minimum microleakage was found in group IV (Endoflas + NaOCI + EDTA). Endoflas FS exhibits less apical microleakage than ZOE eugenol as an obturating material in primary teeth. Hence, Endoflas could be a potential alternative to ZOE eugenol with better sealing ability as an obturating material in primary teeth. Also, the addition of EDTA to irrigation protocol has shown a statistically nonsignificant improvement in microleakage reduction with both obturating materials. Kale YJ, Misal S, Dadpe M, et al. Comparative Evaluation of Microleakage of Zinc Oxide Eugenol and Endoflas as Obturating Materials Using Different Root Canal Irrigants in Primary Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(11):1252-1257.

Remineralizing capacity of zinc oxide eugenol sealer following the addition of nanohydroxyapatite-tyrosine amino acid: An in vivo animal study

ObjectiveAlthough several sealers have been developed, the zinc oxide eugenol (ZOE) sealer is still used in many private dental clinics. This study aimed to compare the biocompatibility and remineralizing capacity οf ZOE sealer with the addition of nanohydroxyapatite-tyrosine amino acid. MethodsThis study was conducted on Twenty rabbits. The rabbits were divided into four groups based on the test observation period (3, 7, 21, and 28 days) following surgical implantation. General anesthesia was administered to each rabbit, and a subcutaneous incision of approximately 1 ± 0.5 cm was made along the symphyseal area of the mandible of each rabbit. Four bone cavities were generated in the interdental space of the lower jaw between the central and molar teeth of each rabbit, with one longitudinal subcutaneous incision. The ZOE sealers were mixed according to the manufacturer's guidelines and directly inserted within the cavities generated at the end of each test period. The animals were sacrificed, and bone biopsy was carried out at the site of testing. The biopsy samples were obtained and subjected to histological analysis using a low-power light microscope (Olympus C ⅹ 21, Japan) and immunohistochemistry using Ki67 antibody. ResultsThe collected information was examined by parametric statistical tests using SPSS software version ‘‘22.” One-way ANOVA and post-hoc Duncan's tests were used to measure the significance among various groups, with statistical significance set, when “P ≤ 0.01”. ConclusionThe 20% mixed endodontic sealer displayed excellent outcomes compared to other experimental groups, as identified by higher new bone formation at every evaluation period.

Effect of electric tooth brushing on retention of long-term provisional composite crowns

Abstract Aim This in-vitro study was conducted to evaluate the influence of electric tooth brushing on the retention of long-term provisional crowns cemented with three cement types. Setting and design In vitro-comparative study. Materials and methods Ninety extracted upper premolars were prepared and provisional crowns were fabricated and cemented with three different cements; group 1: resin-modified zinc oxide-eugenol (i-ZOEn), group 2: zinc oxide noneugenol (Temp Bond NE), and group 3: calcium hydroxide (Dycal). All the specimens were subjected to a chewing simulator with thermocycling (5–55°C) according to the time of exposure to electric tooth brushing (6 and 12 months). A universal testing machine was used for retention test, all specimens were subjected to (pull-out test). Statistical analysis used Two-way analysis of variance (P &lt; 0.001) was considered significant difference in all tests. Results Maximum force (N) at baseline, 6, and 12 months groups for tensile dislodgement of zinc oxide-eugenol cemented crowns was 69.81 ± 4.32, 44.74 ± 4.39, and 41.88 ± 1.03 N, for zinc oxide noneugenol cemented crowns was 57.83 ± 7.44, 34.87 ± 1.07, and 20.22 ± 1.82 N and for calcium hydroxide cemented crowns was 74.61 ± 0.96, 45.05 ± 2.15, and 31.32 ± 8.29 N, respectively, with P value less than 0.001. Conclusion Electric toothbrush effect on long-term provisional crowns was significant for the crowns cemented with three different types. Calcium hydroxide was the most retentive cement at baseline group and 6 month periods with no clinical significance with resin-modified zinc oxide-eugenol. Resin-modified ZOE was the most retentive cement at 12-month periods with a clinically significant difference with calcium hydroxide. Zinc oxide noneugenol was the least retentive cement throughout all the times.

Comparative Evaluation of Mechanical Properties and Bond Strength of Glass Ionomer Cement reinforced with three different concentrations of Silver Nanoparticles as against Conventional Glass Ionomer Cement in Primary Teeth.

Introduction: Restorative dental materials are defined as substances that are used to repair, replace, or enhance a patient’s teeth. Various materials used in paediatric dentistry are zinc oxide eugenol, glass ionomer cement, resin composite, calcium hydroxide, silver amalgam, giomers etc. GIC is a biocompatible material having a low thermal expansion coefficient and fluoride release property. There are still a few drawbacks of GICdue of their poor mechanical properties therefore addition of Silver Nanoparticles demonstrated improved mechanical and bactericidal capabilities. There hasn’t been much study on the quality of the bond contact between silver nanoparticles and dentin, as well as the color’s durability. Aim: To evaluate and compare the mechanical properties and bond strength of Glass ionomer cement reinforced with three different concentrations of silver nanoparticle as against conventional glass ionomer cement in primary Teeth. Materials and Method: Silver nanoparticles will be prepared using three chemicals namely, silver nitrate, sodium citrate and tannic acid. Traditional GIC (GC Fuji II, GC Corporation, Tokyo, Japan) will be purchased. Three different concentrations of silver nanoparticles will be prepared i.e., 0.2, 0.4, and 0.6%. The GIC specimens will then be divided into 4 groups: GIC without silver nanoparticles (AgNPs),0.2%,0.4% and 0.6% AgNPs. Mechanical properties will be checked such as compressive, tensile, and bond strength using Universal Testing Machine. Expected Results: GIC reinforced with silver nano particles is expected to have better mechanical strength, less microleakage and wear resistance, greater fracture resistance and adhesive bond strength. Conclusion: GIC reinforced with silver nano particles will be expected to have better mechanical and physical properties than conventional Type II GICs and is expected to be a promising material for restoration in primary teeth.

Effect of zinc oxide-eugenol endodontic paste on planktonic aggregates and biofilm of Enterococcus faecalis - An atomic force microscopy evaluation

ObjectiveThis work aimed to evaluate the in vitro effect of zinc oxide-eugenol paste (ZOE) on planktonic aggregates (EfPA) and biofilm (EfBio) of Enterococcus faecalis, focusing on their morphological aspects observed and analyzed using atomic force microscopy (AFM). DesignThe eugenol and paste were characterized by Gas Chromatography coupled with Mass Spectrometry (GC-MS) and Fourier Transform Infrared Spectroscopy (FTIR), respectively. The effect of ZOE on EfPA and EfBio was evaluated by a direct-contact test through colony counting and crystal violet staining protocol. AFM images of untreated and treated EfPA and EfBio growth on bovine dentin were obtained to analyze the morphological damage caused by the treatments. ResultsThe characterization showed high purity in the eugenol composition and chemical interaction between the components of the paste. A bactericidal effect on aggregates was observed after 6 h of exposure, and on biofilm after 24 h of treatment (p < 0.001). A disruptive effect on the biofilm was also evident. AFM images revealed the formation of EfPA, with a notable presence of an exopolysaccharide matrix. After 6 h of ZOE treatment, there was a significant increase in the size and surface roughness profile of treated cells (p < 0.05). Loss of typical cell morphology was observed after 24 h. The effect on the biofilm showed a tendency towards a less condensed biofilm pattern in the treated group, with no differences in surface roughness. ConclusionZOE presents bactericidal action on EfPA and EfBio, promoting significant morphological changes after treatment, especially in the aggregates.

Comparative In vitro Analysis of Push-Out Bond Strength of Different Root Canal Sealers to Root Dentin

ABSTRACT Aim: The study’s objective is to assess the bond strengths of four different endodontic sealers to root dentin using a push-out test technique. Material and Method: Sixty single-rooted teeth were selected and decoronated. Canal instrumentation was done using rotary files and divided into four groups (n = 15) based on the sealer used. Group 1: zinc oxide eugenol (ZOE)-based, Group 2: epoxy resin-based, Group 3: methacrylate-based, and Group 4: bioceramic. Following obturation with Gutta Percha, each tooth was prepared with root portions that were 2 mm thick at the apical and middle 1/3 so that universal testing equipment could measure the push-out bond strength. Tukey’s post hoc tests and one-way ANOVA were used to examine the data. Result: According to the results, group 4 had the strongest push-out relationship, followed by groups 3, 2, and 1, respectively. It can be concluded that the bioceramic sealers have superior bond strengths. Conclusion: Bioceramic sealers demonstrated the highest bond strengths to root dentin, outperforming methacrylate, epoxy resin, and zinc oxide eugenol sealers in the push-out test.

Retrospective radiographic study comparing unintentional extrusion of gutta-percha versus sealer on teeth with periapical radiolucency.

The purpose of the present study was the radiographic evaluation of endodontically treated teeth presenting periapical radiolucency and unintentional overfilling with gutta-percha or sealer on treatment outcome and persistence of the extruded materials. After assessment using periapical index (PAI), 202 roots filled with gutta-percha and zinc oxide-eugenol sealer (Roth 811, Roth International), exhibiting unintentional overfilling and periapical radiolucency were selected. All cases had at least 1 year of follow-up. Type of extruded material, periapical status, and removal/persistence of the extruded material were evaluated by two independent observers. Data were statistically analyzed using logistic and linear regression analysis. Tooth location (P .001), follow-up period (P .001), and type of extruded material (P &#61; .004) significantly influenced treatment outcomes. Specifically, posterior roots exhibited better outcomes compared to anterior, and cases with overfilling of sealer showed superior healing potential compared to those with gutta-percha overfilling. Additionally, longer recall periods were associated with improved treatment success. The type of extruded material (P .001) and follow-up period (P .001) significantly affected the presence of extruded material in the follow-up radiograph. The persistence of extruded material was greater when gutta-percha was extruded, and extruded materials were less detected when the follow-up period was longer. Teeth with periapical radiolucency and unintentional overfilling require longer follow-up intervals for effective monitoring of healing. Treatment outcome was associated with the type of extruded materials used in the present study. The persistence of those materials in the periapex did not affect healing.

Tissues response and bone-forming capacity of zinc oxide–eugenol sealer following the addition of nanohydroxyapatite-tyrosine amino acid: An in vivo animal study

Abstract Introduction: The zinc oxide–eugenol (ZOE) sealer is used till now in many private dental clinics although many sealers have been developed. The current study aimed to compare the biocompatibility and remineralizing capacity of ZOE sealer following the addition of nanohydroxyapatite-tyrosine amino acid. Materials and Methods: Twenty rabbits were used in this investigation, and they were divided into four groups based on the test observation period (3, 7, 21, and 28 days) following surgical implantation. General anesthesia was given for each rabbit with a subcutaneous incision of about 1 cm ± 0.5 cm made along the symphyseal area of the mandible of each rabbit. Each rabbit had four bone cavities generated in the interdental space of the lower jaw between the central and molar teeth, with one longitudinal subcutaneous incision. The ZOE sealers were mixed and directly inserted within the cavities as follows: ZOE alone on the central area of the right side of the jaw (Group A), 10% nHAp and Tyrosine mixed ZOE at the molar area (Group B), empty cavity (−ve control) located at the central area of the left side of the jaw (Group C) and 20%/nHAp and Tyrosine mixed ZOE located at the molar area on the left side of the jaw (Group D). Animals were scarified and bone biopsy samples from the tested parts were collected. Histological analysis was performed using a low-power light microscope and immunohistochemistry using runt-related transcription factor 2 (Runx2) antibody. Data were statistically analyzed utilizing the SPSS software. One-way analysis of variance was used and the post hoc test Duncan’s test was utilized to measure the significance among various groups at P ≤ 0.01. Results: The inflammatory process decreased over time for all experimental groups, associated with an increase in granulation tissue formation which was gradually decreasing over time to permit an increase in new blood vessels and new bone formation for all experimental groups that increased with time. Group D displayed the highest levels of new bone formation. Runx2 antibody expression declined progressively, particularly in Group D on 28 days. Conclusion: Superior new bone formation and biocompatible properties were demonstrated by the 20% nHAp and tyrosine mixed ZOE sealer.

Adrenaline in pulp capping treatment of reversible pulpitis.

The role of epinephrine in the treatment of pulp capping in patients with reversible pulpitis is not clear. To explore the role of epinephrine in the treatment of pulp capping in patients with reversible pulpitis. A total of 100 patients with reversible pulpitis who were treated in Anhui Jieshou People's Hospital from January 2020 to December 2021 were included in the study. They were categorized into an observation group (n = 50; treatment with adrenaline) and a control group (n = 50; treatment with zinc oxide eugenol paste). The 24-h postoperative pain, regression time of gingival congestion and redness, clinical efficacy, and incidence of adverse reactions were compared between the groups. Patients were further categorized into the ineffective and effective treatment groups based on clinical efficacy. Logistic multiple regression analysis explored factors affecting the efficacy of pulp capping treatment. A significant difference in 24-h postoperative pain was observed between the groups (P < 0.05), with a higher proportion of grade I pain noted in the observation group than in the control group (P < 0.01). The regression time of gingival congestion and swelling was lower in the observation group (2.61 ± 1.44 d and 2.73 ± 1.36 d, respectively) than in the control group (3.85 ± 1.47 d and 4.28 ± 1.61 d, respectively) (P < 0.05). The 2-wk postoperative total effective rate was lower in the control group (80.00%) than in the observation group (94.00%) (P < 0.05). The incidence of adverse reactions was not significantly different between the control (14.00%) and observation (12.00%) groups (P > 0.05). The proportion of adrenaline usage was lower (P < 0.05) and that of anaerobic digestion by Streptococcus and Fusobacterium nucleatum was higher in the ineffective treatment group than in the effective treatment group (P < 0.05). Logistic multiple regression analysis revealed adrenaline as a protective factor (P < 0.05) and anaerobic digestion by Streptococcus and F. nucleatum as risk factors for pulp capping in reversible pulpitis (P < 0.05). Adrenaline demonstrated therapeutic efficacy in pulp capping treatment for reversible pulpitis, reducing pain and improving clinical symptoms safely. It is a protective factor for pulp capping, whereas Streptococcus and F. nucleatum are risk factors. Targeted measures can be implemented to improve clinical efficacy.

A Novel Combination of Zinc Oxide with Two Essential Oils Exerts Antimicrobial Effect against Endodontic Pathogens In Vitro.

Evaluating the antimicrobial efficacy of the novel combinations of zinc oxide mixed with ajwain oil (ZNOA) and combination of ajwain and eugenol (ZNOAE) vs conventionally used zinc oxide eugenol (ZNOE) against endodontic pathogens like Escherichia coli and Enterococcus faecalis. The pure cultures of E. coli (MTCC 443) and E. faecalis (MTCC 439) were revived and grown on selective cultural media. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the test materials were determined correspondingly through sequential dilution and agar well diffusion methods, as per Clinical and Laboratory Standard Institute (CLSI) guidelines. The data values were presented as mean ± standard deviation (SD). The comparisons among groups were completed through the one-way analysis of variance (ANOVA) test, whereas intragroup pairwise comparisons were completed using the unpaired t-test (p < 0.05). Minimum inhibitory concentration values against E. coli and E. faecalis of ZNOE were 250 and 500 µg/mL, ZNOA was 250 µg/mL, and ZNOAE were 125 and 250 µg/mL, correspondingly. MBC values in the form of inhibition zone against E. coli by ZNOE were 21.33 ± 1.53 mm, ZNOA 18.67 ± 1.53 mm, and ZNOAE 20.33 ± 1.53 mm. The E. faecalis inhibition zone for ZNOE was 14.33 ± 2.08 mm, ZNOA 18.67 ± 2.08 mm, and ZNOAE 24.33 ± 1.53 mm. All test materials demonstrated good antibacterial efficacy. However, between the novel combinations of test materials, ZNOA showed better antimicrobial efficacy against resistant endodontic pathogens than ZNOE. Dahake PT, Joshi SS, Kale YJ, et al. A Novel Combination of Zinc Oxide with Two Essential Oils Exerts Antimicrobial Effect against Endodontic Pathogens In Vitro. Int J Clin Pediatr Dent 2024;17(S-1):S11-S16.