Reciproc and Reciproc Blue in the removal of bioceramic and resin-based sealers in retreatment procedures

Objectives

To compare the remaining root canal filling material, dentin removal, apical transportation, and apical extrusion of debris after the retreatment of canals filled with bioceramic or resin-based sealers using the Reciproc or Reciproc Blue instruments.

Materials and methods

Sixty mandibular molars with severely curved mesial roots were selected. The samples were initially instrumented with Reciproc (R25) and then divided into four experimental groups according to the endodontic sealer and retreatment instrument (n = 15): BC Sealer/Reciproc (BCRC), BC Sealer/Reciproc Blue (BCRB), AH Plus/Reciproc (AHRC), and AH Plus/Reciproc Blue (AHRB). The procedure time was measured, and an Eppendorf tube was used in each root canal to store the debris extrusion. The samples were scanned by micro-CT before and after retreatment. The apical transportation, volume of dentin, and filling material were evaluated.

Results

There were no significant differences in the reduction of the volume of obturator material or dentin removal between groups (p > .05). There were also no differences in the amount of extruded material or apical transportation (p > .05). The retreatment time for the AHRC group was significantly lower than that for the other groups (p = .004).

Conclusions

All tested instruments obtained similar efficacy in filling material removal procedures, although no system completely removed the filling material. Retreatment of canals filled with bioceramic BC Sealer may be more time consuming.

Clinical relevance

This study reported that Reciproc and Reciproc Blue can be indicated in retreatment of severely curved root canals filled either with bioceramic or resin-based sealers.

     

Effect of Ultrasonic Activation of Endodontic Sealers on Intratubular Penetration and Bond Strength to Root Dentin

IntroductionThis study aimed to evaluate the effect of ultrasonic activation (UA) of endodontic sealers on dentin tubule penetration and the bond strength to root dentin.MethodOne hundred single-rooted teeth were prepared with 40.06 nickel-titanium instruments and divided into 2 groups: with or without UA. Three resin-based sealers (MTA Fillapex [Angelus Dental Solutions, Londrina, PR, Brazil], Sealer Plus [MK Life Medical and Dental Products, Porto Alegre, RS, Brazil], and AH Plus [Dentsply, DeTrey GmbH, Konstanz, Germany]; n = 20) and 2 calcium silicate–based sealers (Sealer Plus BC [MK Life Medical and Dental Products] and EndoSequence BC [Brasseler, Savannah, GA], n = 20) were used and subdivided (n = 10) according to the protocols. Fluo-3 (Thermo Fisher Scientific, Waltham, MA) and rhodamine B dyes were added to the calcium silicate- and resin-based sealers, respectively. In the UA groups, the activation was performed for 40 seconds followed by lateral compaction. Samples were transversely sectioned to evaluate the dentin tubule penetration and the bond strength to root dentin. The penetration data were analyzed with the Student t test, 1-factor analysis of variance, and Bonferroni tests. Bond strength was evaluated using the Student t test, Kruskal-Wallis, and Dunn post hoc test.ResultsResin-based sealers showed the highest tubule penetration without UA (P < .05). UA significantly enhanced MTA Fillapex and Endosequence BC dentin tubule penetration (P < .05). AH Plus and Sealer Plus BC improved their bond strength to root dentin after UA (P < .05). AH Plus/UA, Sealer Plus/UA, and Sealer Plus BC/UA presented the highest bond strength values (P < .05). Adhesive failures were predominant in all groups regardless of the use of ultrasound.ConclusionsUA interferes with tubule penetration and the bond strength to root dentin of resin- and calcium silicate–based sealers.     

The Effect of Primary Root Canal Treatment on Dentinal Tubule Penetration of Calcium Silicate–based Sealers during Endodontic Retreatment

IntroductionThe aim of this study was to evaluate the effect of previous root canal treatment on dentinal tubule penetration of calcium silicate–based sealers during endodontic retreatment and to compare 2 different (commonly used and modified) tubule penetration depth measurement techniques.MethodsThe crowns of mandibular premolar teeth were removed, and root canals were prepared (ProTaper Universal; Dentsply Sirona, York, PA) and obturated using AH Plus (AH; Dentsply DeTrey, Konstanz, Germany), MTA Fillapex (MTAF; Angelus, Londrina, Brazil), and WellRoot ST (WRST; Vericom, Gyeonggi-do, South Korea); 0.1% red Rhod-2 dye (Chemodex, St Gallen, Switzerland) was added to the sealers. After storage for 3 weeks (37°C, 100% humid), the following sealer combination subgroups were created (the sealer used during the primary root canal treatment/the sealer used during the retreatment, n = 8): AH/AH, AH/MTAF, and AH/WRST; MTAF/AH, MTAF/MTAF, and MTAF/WRST; and WRST/AH, WRST/MTAF, and WRST/WRST. Green Fluo-3 dye (0.1%) was added to the sealers during retreatment. Sealer penetration depths were measured at 8 points and averaged, and the ratio of the retreatment sealer to the initial sealer was recorded as the mean tubule penetration depth ratio in the first technique, whereas the percentage of the circumferential penetration area ratios of the retreatment and initial sealers was calculated in the second technique. Statistical analyses were performed using Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests.ResultsThe mean penetration depth of AH and MTFA was found to be higher at the coronal third region in the control groups (P < .05). Both methods showed a significant difference among the groups at the coronal and median regions (P < .05). The AH/WRST, MTAH/AH, MTAF/MTAF, MTAF/WRSTS, and WRST/WRST groups showed deeper tubule penetration (first technique, P = .01). Both techniques showed that the penetration depth of the sealers was the same at the apical region (P > .05), whereas a difference was found among the techniques at the coronal and median regions. The sealers used in the previous root canal treatment limited the penetration depth of the sealers used during the retreatment process (P < .05). When MTAF was used as the initial sealer, the penetration depth of the second sealer did not change, whereas if WRST was the initial sealer, the penetration depth of the sealers at the median and apical regions is negatively affected during the retreatment process (P < .05).ConclusionsPrevious root canal treatment affects the penetration depth of calcium silicate–based sealers. The use of AH Plus and MTA Fillapex during the retreatment process showed an advantage. Both measurement techniques showed similar performances at the apical region, whereas the results varied at the coronal and midcoronal regions; therefore, a more stable sealer penetration measurement technique is still necessary.     

Comparative evaluation of cone beam CT and micro-CT on blooming artifacts in human teeth filled with bioceramic sealers

Aim

To assess blooming artifacts caused by root canal sealers in CBCT images compared with those that appeared in micro-CT scan images used as references.

Materials and method

Thirty freshly extracted human mandibular central incisors were used. Root canals were prepared with nickel titanium files with an ISO size 40/0.06 taper and filled with a single cone (40/0.06 taper) and three different sealers. The samples were divided into the following three groups with 10 roots each: (I) AH Plus sealer; (II) Sure Seal Root; and (III) Total BC sealer. Teeth were scanned with the same voxel sizes (0.2 mm) in different CBCT devices and the micro-CT images were acquired as reference images.

Results

Significantly different results in terms of blooming artifacts were detected between CBCT and micro-CT images, as well as among the CBCTs images. The canals filled with AH Plus sealer showed more blooming artifacts than those filled with bioceramic sealers (p < 0.05). Additionally, the worst blooming artifact was observed when the images were acquired with lower kilovoltage peak.

Conclusion

The appearance of blooming artifacts is dependent on sealer and CBCT, and their effects are significantly worse than they are in micro-CT images. The differential effect of different sealers and distinct CBCT protocols should be further investigated to enable the use of bioceramic sealers without a significant impact on post-treatment imaging.

Clinical relevance

Root canal sealers showed a different extent of blooming artifact in CBCT images. Hence, researchers and clinicians should be aware of these artifacts before conducting endodontic evaluations using CBCT images.

     

The Antimicrobial Effect of Bioceramic Sealer on an 8-week Matured Enterococcus faecalis Biofilm Attached to Root Canal Dentinal Surface

IntroductionThe aim of this study was to test the antibacterial activity of bioceramic sealer in comparison with AH Plus (Dentsply International Inc, York, PA) on 8-week-old Enterococcus faecalis biofilms attached to root canal surfaces using a dentin infection model.MethodsThe canal surfaces of single-rooted intact extracted teeth were infected by growing E. faecalis biofilms for 8 weeks. AH Plus sealer and EndoSequence BC Sealer (Brasseler USA, Savannah, GA) were placed on the root canal wall of the dentin specimens for 24 hours and 2 weeks in humid conditions at 37°C. Infected samples incubated with no sealers for similar periods were used as the negative controls. Specimens were labeled with fluorescent viability staining, and confocal laser scanning microscopy was used as an assessment tool of the proportions of dead and live bacteria on canal walls after exposure to root canal sealers for the determined times.ResultsEndoSequence BC Sealer killed significantly more E. faecalis in biofilm attached to the canal surfaces when compared with AH plus sealer and control at both time points (P < .05–.0005).ConclusionsEndoSequence BC Sealer exhibited significant antimicrobial capacity in the presence of dentin for up to 2 weeks on an 8-week-old E. faecalis biofilm in comparison with AH Plus sealer.     

In vitro evaluation of the antibacterial effect of four root canal sealers on dental biofilms

Objectives

To dynamically evaluate the effect of four root canal sealers on the killing of biofilms within dentinal tubules.

Materials and methods

Dentin blocks were prepared for infection of the dentinal tubules. Enterococcus faecalis VP3-181 and multi-species bacteria from two donors were cultured. After 3 days of incubation, the infected dentin specimens were rinsed with sterile water for 1 min and subjected to treatment. Additionally, multi-species bacteria from donor 1 were incubated for 3 weeks to allow biofilm maturation and then the specimens were subjected to treatment. Gutta-percha-treated dentin specimens comprised the control group. A root canal sealer (bioceramic sealers: EndoSequence BC Sealer, ProRoot Endo Sealer, or GuttaFlow Bioseal; and a traditional silicone-based sealer: Guttaflow 2) was spread onto the canal walls of the dentin. The specimens were examined with confocal laser scanning microscopy at 7, 30, or 60 days.

Results

In the 3-day-old biofilm group, the proportion of killed bacteria decreased significantly from the first 7 days of treatment to 60 days of treatment for all sealers (p?<?0.05). In the 3-week-old biofilm group, 60 days of exposure to bioceramic sealers resulted in more significant dead bacteria than 7-day exposures of the biofilms (p?<?0.05). Bioceramic sealers were more effective in killing bacteria than the GuttaFlow 2 sealer (p?<?0.05).

Conclusions

Calcium silicate–based sealers showed good antimicrobial effects against biofilms within dentinal tubules, especially in the first week in young biofilms. There is no substantive antibacterial activity observed for the examined root canal sealers against young dentinal tubule biofilms.

Clinical relevance

The bioceramic root canal sealers examined demonstrate minimal additional antibacterial effects after long-term exposure to young biofilms.

     

Evaluation of Physicochemical Properties of a New Calcium Silicate–based Sealer,Bio-C Sealer

IntroductionCalcium silicate–based materials have been proposed as root canal sealers for root canal treatment. The aim of this study was to evaluate the physicochemical properties of a new calcium silicate–based sealer (Bio-C Sealer; Angelus, PR, Brazil) compared with a calcium silicate endodontic sealer (TotalFill BC Sealer; FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) and an epoxy resin sealer (AH Plus; Dentsply DeTrey, Konstanz, Germany).MethodsThe setting time and flow were evaluated based on ISO 6876 standard. The pH value was evaluated after different time intervals of storage in deionized water (1, 7, 14, and 21 days). Radiopacity was evaluated by radiographic analysis in millimeters of aluminum. Solubility and volumetric change were evaluated after 30 days of immersion in distilled water. Solubility was assessed by mass loss (%), and volumetric change was evaluated by micro–computed tomographic imaging. The data were submitted to analysis of variance and Tukey statistical tests (P < .05).ResultsTotalFill BC Sealer and Bio-C Sealer were similar regarding radiopacity, volumetric change, and pH values (P > .05). Bio-C Sealer presented the shortest setting time and the highest flow and solubility (P < .05). AH Plus showed the highest radiopacity and the lowest flow, pH, solubility, and volumetric change (P < .05).ConclusionsBio-C Sealer showed a short setting time, alkalinization ability, and adequate flow and radiopacity as well as low volumetric change. However, this sealer had higher solubility than the rates required by ISO 6876 standard.     

Setting properties and cytotoxicity evaluation of a premixed bioceramic root canal sealer

Introduction

This study investigated the setting time and micohardness of a premixed calcium phosphate silicate-based sealer (EndoSequence BC Sealer; Brasseler USA, Savannah, GA) in the presence of different moisture contents (0-9 wt%). The moisture content that produced the most optimal setting properties was used to prepare set EndoSequence BC Sealer for cytotoxicity comparison with an epoxy resin-based sealer (AH Plus; Dentsply Caulk, Milford, DE).

Methods

Standardized disks were created with BC Sealer, AH Plus, Pulp Canal Sealer EWT (positive control) (SybronEndo, Orange CA), and Teflon (Small Parts Inc., Miami Lakes, FL; negative control). Disks were placed in Transwell Inserts, providing indirect contact with MC3T3-E1 cells. Succinate dehydrogenase activity of the cells was evaluated over a 6-week period using MTT ((3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. Cytotoxicity profiles of BC Sealer and AH Plus were fitted with polynomial regression models. The time for 50% of the cells to survive (T_0.5) was analyzed using the Wald statistic with a two-tailed significance level of 0.05.

Results

BC Sealer required at least 168 hours to reach the final setting using the Gilmore needle method, and its microhardeness significantly declined when water was included in the sealer (P = .004). All set sealers exhibited severe cytotoxicity at 24 hours. The cytotoxicity of AH Plus gradually decreased and became noncytotoxic, whereas BC Sealer remained moderately cytotoxic over the 6-week period. A significant difference (P < .001) was detected between T_0.5 of BC Sealer (5.10 weeks; 95% confidence interval [CI], 4.69-5.42, standard error [SE] = 0.09) and T_0.5 of AH Plus (0.86 weeks; 95% CI, 0.68-1.05; SE = 0.18).

Conclusions

Further studies are required to evaluate the correlation between the length of setting time of BC Sealer and its degree of cytotoxicity.     

Physicochemical Properties and Biocompatibility of Various Bioceramic Root Canal Sealers: In Vitro Study

IntroductionThe aim of this study was to compare the physicochemical properties and biocompatibility of various calcium silicate–based bioceramic sealers (CSBSs).MethodsFour recently developed CSBSs, including AH Plus Bioceramic Sealer (AHB), EndoSequence BC Sealer (ESB), TotalFill BC Sealer (TTB), and Bio-C Sealer (BIC), were compared with the epoxy resin–based sealer AH Plus (AHP). Their physical properties, including flow, setting time, radiopacity, dimensional stability, and pH, were evaluated according to the International Organization for Standardization (ISO) 6876. Their cytotoxicity in human periodontal ligament fibroblast (hPDLF) was assessed through the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and compared. Additionally, cell attachment to the sealer surface was analyzed using green fluorescent protein and confocal laser scanning microscopy to evaluate cell viability. Data were analyzed using a one-way analysis of variance to determine the difference between groups for categorical variables, followed by Tukey's post hoc test at the significance level of 95%.ResultsThe flow, setting time, and radiopacity of all tested CSBSs satisfied the ISO 6876/2012 standards. Further, these CSBSs showed shrinkage after immersion in distilled water for 30 days and complied with the ISO 6876/2001 requirements. The pH values of AHB, ESB, TTB, and BIC were greater than 11, whereas AHP had a pH of 6.69 after 4 weeks. CSBS showed excellent biocompatibility compared with that of AHP (P < .05). Confocal laser scanning microscopy showed that alive hPDLFs were attached well to all the tested CSBSs but not to AHP.ConclusionsCSBSs have similar physical characteristics within the ISO standards and higher biocompatibility than epoxy resin–based sealers.     

Volume and Power of Expansion of Novel Polyurethane-based Sealers

IntroductionShrinkage and lack of interfacial adaptation between endodontic sealers and root canal walls may jeopardize the root canal treatment outcome. This study aimed to evaluate the volume and power of expansion (and the relationship between the two) of three novel root canal sealers (polyurethane expandable sealer [PES], zeolite + PES [ZPES], and elastomeric polyurethane sealer [EPS]) in comparison with an epoxy-resin based sealer (AH Plus) and a calcium silicate-based sealer (EndoSequence BC).MethodsThis study utilized 36 cylinders (30 plastic graduated cylinders for volume of expansion and 6 steel cylinders for power of expansion) (4 × 10 mm) filled with PES, ZPES, EPS, AH Plus, EndoSequence BC, or water (n = 5/group). The plastic graduated cylinders were inserted inside a customized Linear Swell Meter apparatus to measure the percentage of volumetric expansion. The steel cylinders were placed inside a Linear Swell Meter apparatus mounted onto a universal testing machine to measure the maximum pressure in psi. Specimens were tested for 72 hours for both volume and power of expansion tests. Data were analyzed using Kolmogorov-Smirnov, one-way ANOVA, Post Hoc Tukey, and Pearson correlation tests (P < .05).ResultsThe volume of expansion of PES, ZPES, and EPS was significantly higher than in AH Plus and EndoSequence BC (P < .05). For the power of expansion, no significant differences were found between the root-filling materials (P > .05). No correlation was seen between the volume and power of expansion (P > .05).ConclusionAlthough polyurethane-based sealers showed a significantly higher volume of expansion compared to AH Plus and EndoSequence BC, their power of expansion did not increase significantly.     

Assessment of Root Canal Sealers Loaded with Drug-Silica Coassembled Particles Using an In Vitro Tooth Model

IntroductionThe purpose of this study was to assess the antimicrobial activity of root canal sealers modified with novel highly loaded antimicrobial drug-silica coassembled particles (DSPs) on Enterococcus faecalis–infected root canal dentin.MethodsDSPs were synthesized through coassembly of silica and octenidine dihydrochloride (OCT) surfactant drug (35% w/w OCT). DSPs (1% wt of the total mass of the sealer) were mixed homogenously with either epoxy resin sealer (AH Plus [AH]; Dentsply Sirona, Tulsa, OK) or calcium silicate–based sealer (EndoSequence BC Sealer [BC]; Brasseler, Savannah, GA). To assess the antimicrobial activity of DSP-loaded sealers, the apical third of single-rooted teeth was obtained and infected with E. faecalis for 3 weeks followed by the application of experimental (DSP-loaded) sealers or corresponding controls for up to 28 days. Microbiological analysis and laser scanning confocal and scanning electron microscopy were used to determine the colony-forming unit (CFU)/mL, the percentage of live bacteria, and the intratubular bacterial and sealer penetrations. Factorial analysis of variance and Tukey post hoc tests were used to assess the antimicrobial effect of DSPs on different sealers.ResultsAll experimental groups showed significant reductions in CFUs at all-time points compared with positive controls (P < .05). The addition of DSPs to BC significantly reduced the CFUs (2.11 ± 0.13, 2.22 ± 0.19, and 2.25 ± 0.17 at 1, 7, and 28 days, respectively) compared with the unmodified sealer (3.21 ± 0.11, 4.3 ± 0.15, and 4.2 ± 0.2 at 0, 7, and 28 days). DSPs enhanced the antimicrobial performance of AH only at 1 day (4.21 ± 0.17 vs 5.19 ± 0.12, P < .05). AH and AH + DSPs showed higher bacterial viability compared with BC and BC + DSPs at all incubation periods (P < .05).ConclusionsLoading endodontic sealers with DSPs had a material-dependent effect on the antimicrobial properties and could reduce the incidence of secondary infections.     

Comparative assessment of apical sealing ability of three different endodontic sealers: A scanning electron microscopic study

AimThe present in vitro SEM study compared the apical sealing ability of three different endodontic sealers used in single cone obturation technique.Material and method45 freshly extracted mandibular premolars with single canal and fully formed apices were selected. The samples were decoronated at/below the cementoenamel junction (CEJ) obtaining root lengths of 15 mm. The samples were instrumented using ProTaper rotary file system SX-F2. Following instrumentation the samples were randomly divided in three different groups for three different sealers to be used in single cone obturation technique. Group 1 EndoSequence BC, Group 2 GuttaFlow 2 and Group 3 AH Plus. The sealers were allowed to set completely. Following this the samples were longitudinally sectioned at the apical third and gold sputtered for SEM evaluation. The interphase between the radicular dentin and the root canal filling material were obtained in micrometers (μm) from the SEM images. Statistical analysis was performed.ResultsThe groups exhibited a statistically significant difference (p < 0.01). Group 3 presented with the highest interphase distance (p < 0.01), whereas Group 1 and 2 exhibited a statistically similar values (p > 0.05).ConclusionThe GuttaFlow 2 and Endosequence BC endodontic sealers showed better adaptation to the radicular dentin as compared to AH Plus sealer.     

Drug-Silica Coassembled Particles Improve Antimicrobial Properties of Endodontic Sealers

IntroductionThe purpose of this study was to assess the antimicrobial activity and flow of root canal sealers after incorporating novel highly loaded antimicrobial drug-silica coassembled particles (DSPs).MethodsDSPs were synthesized through coassembly of silica and octenidine dihydrochloride (OCT) antimicrobial surfactant. DSPs were loaded (1% and 2% wt) into epoxy resin sealer (AH Plus [AH]; Dentsply DeTrey GmbH, Konstanz, Germany) or calcium silicate–based sealer (EndoSequence Bioceramic Sealer (BC); Brasseler, Savannah, GA). OCT release from DSP-modified sealers was determined using liquid chromatography. Antimicrobial activity of sealers against planktonic or biofilm form Enterococcus faecalis was assessed using direct contact and membrane restricted tests. Sealer flow was tested according to ISO6876:2012.ResultsOCT release from BC + 1% or 2% DSPs was above the minimum inhibitory concentration following 2 days throughout the 30-day experiment, whereas OCT release from AH + 1% or 2% DSP was significantly below the minimum inhibitory concentration against E. faecalis (4 μg/mL) over the whole 30-day experimental period. All materials (with or without DSPs) killed planktonic bacteria initially. AH ± 1% or 2% DSPs had no antimicrobial activity after 7 days. BC + 1% or 2% DSPs maintained antibacterial activity over the 30-day period. Both modified and unmodified sealers completely inhibited the growth of E. faecalis biofilms after 24 hours of contact. DSPs decreased the flow of AH and BC sealers; for AH, the reduction was proportional to the amount of DSPs added. All modified and unmodified sealers, except for AH + 2% DSPs, were within the acceptable limits of ISO 6876 flow tests.ConclusionsDSPs enhanced the antimicrobial performance of BC but not AH, whereas the material’s flow remained compliant with ISO 6876 standards. Depending on the sealer, DSPs may enhance antimicrobial efficacy in root canal treatment and potentially improve treatment outcome.     

Physical Properties of 5 Root Canal Sealers

Introduction

The aim of this study was to evaluate the pH change, viscosity and other physical properties of 2 novel root canal sealers (MTA Fillapex and Endosequence BC) in comparison with 2 epoxy resin-based sealers (AH Plus and ThermaSeal), a silicone-based sealer (GuttaFlow), and a zinc oxide-eugenol–based sealer (Pulp Canal Sealer).

Methods

ISO 6876/2001 specifications were followed. The pH change of freshly mixed and set sealers was evaluated during periods of 1 day and 5 weeks, respectively. The viscosity was investigated at different injection rates (72, 10, and 5 mm/min) at room temperature by using a syringe-based system that was based on the Instron 3360 series universal testing system.

Results

The flow, dimensional change, solubility, and film thickness of all the tested sealers were in agreement with ISO 6876/2001 recommendations. The MTA Fillapex sealer exhibited a higher flow than the Endosequence BC sealer (P < .05). The MTA Fillapex and Endosequence BC sealers showed the highest film thicknesses among the tested samples. The Endosequence BC sealer exhibited the highest value of solubility, which was in accordance with 3% mass fraction recommended by the ISO 6876/2001, and showed an acceptable dimensional change. The MTA Fillapex and Endosequence BC sealers presented an alkaline pH at all times. The pH of fresh samples of the AH Plus and ThermaSeal sealers was alkaline at first but decreased significantly after 24 hours. The viscosity of the tested sealers increased with the decreased injection rates.

Conclusions

The tested sealers were pseudoplastic according to their viscosities as determined in this study. The MTA Fillapex and Endosequence BC sealers each possessed comparable flow and dimensional stability but higher film thickness and solubility than the other sealers tested.     

Evaluation of Physicochemical Properties of a New Root Canal Sealer

Introduction

The aim of this study was to evaluate some of the physicochemical properties of a new root canal sealer.

Apical sealing ability of five endodontic sealers

Because apical leakage may be a cause of failure of endodontic treatment, the purpose of this study was to compare the apical seal provided by five endodontic sealers. After cleaning and shaping procedures, the root canals of 75 human cuspids were obturated by lateral condensation using gutta-percha and the following sealers: Kerr Pulp Canal Sealer EWT, Grossman's sealer, ThermaSeal, Sealer 26, and AH Plus. These root-filled teeth were then maintained at 37 degrees C and 100% humidity for two days. After immersion in a solution containing black India ink and fetal bovine serum for five days, the teeth were demineralised and rendered transparent. The extent of dye penetration was examined under a stereomicroscope. The results showed that Grossman's sealer exhibited significantly more leakage than the other sealers, except ThermaSeal. There was no significant difference between ThermaSeal and AH Plus. No significant differences were observed for Kerr Pulp Canal Sealer EWT when compared with either ThermaSeal or AH Plus. There was significantly less leakage for Sealer 26 when compared with the other sealers tested, except AH Plus.     

Penetration of dentinal tubules by endodontic sealer cements in extracted teeth and in vivo

AIM: To compare the depth and consistency of penetration of three different root canal sealer cements into dentinal tubules in extracted teeth and to measure the penetration of an epoxy resin-based sealer cement in vivo. METHODOLOGY: Root canals of 50 extracted human pre-molar teeth were prepared and obturated using three different sealer cements based on epoxy resin (AH26), zinc oxide eugenol (Pulp Canal Sealer EWT) and methacrylate resin (EndoREZ). Five teeth filled without sealer were used as controls. Teeth were sectioned and prepared for observation using scanning electron microscopy. A further 12 teeth with a history of successful root filling and subsequent extraction were collected and sectioned. The depth of sealer penetration into dentinal tubules was measured and the consistency and appearance of the sealer within the tubules observed. RESULTS: AH26 demonstrated the deepest penetration (1337 microm), followed by EndoREZ (863 microm) and Pulp Canal Sealer EWT (71 microm). The difference in penetration between all sealer groups was found to be statistically significant (P < 0.05). The resin-based sealers appeared to penetrate tubules more consistently. In the clinical cases, all teeth demonstrated sealer penetration to varying depths (98-1490 microm). CONCLUSIONS: The depth and consistency of dentinal tubule penetration of sealer cements appears to be influenced by the chemical and physical characteristics of the materials. Resin-based sealers displayed deeper and more consistent penetration. Penetration depths observed for the epoxy resin-based sealer in vivo were consistent with that found in the experimental model.     

Dentin Extends the Antibacterial Effect of Endodontic Sealers against Enterococcus faecalis Biofilms

Introduction

The purpose of this study was to evaluate the antimicrobial effects of root canal sealers on Enterococcus faecalis biofilms in dentinal tubules by using a novel dentin infection model.

Methods

Cells of E. faecalis were introduced into the dentinal tubules by centrifugation and incubated in brain-heart infusion broth for 3 weeks. An equal thickness of AH Plus, Endosequence BC sealer (BC sealer), and pulp canal sealer EWT (PCEWT) was placed on the root canal wall of the dentin specimens for 1, 7, and 30 days in humid conditions at 37°C. Gutta-percha and water were used in a similar manner as the tested sealers. The proportions of dead and live bacteria inside the dentinal tubules after exposure to root canal sealers were assessed by confocal laser scanning microscopy.

Results

Significantly more bacteria were killed in the 3 sealer groups than in the 2 control groups (P < .05). BC sealer and AH Plus resulted in significantly more dead cells than PCEWT did. There was no statistically significant difference between BC sealer and AH Plus at any time point (P > .05). Thirty days of exposure to BC sealer and AH Plus resulted in significantly more dead bacteria in dentin than 7-day and 1-day exposures in the biofilms, whereas no statistically significant increase of the proportion of dead bacteria was detected between 7-day and 30-day PCEWT (P > .05).

Conclusions

The 3 endodontic root canal sealers had antibacterial effects against E. faecalis in the dentinal tubules. BC sealer and AH Plus had superior antibacterial effects compared with PCEWT. The antibacterial effects of sealers in dentinal tubules continued after setting.     

Comparative in vivo analysis of the sealing ability of three endodontic sealers in post-prepared root canals

AIM: To compare the sealing ability of the endodontic sealers AH Plus, Sealer 26 and Endofill in premolar teeth of dogs exposed to the oral cavity after post-preparation. METHODOLOGY: Forty teeth with two canals each underwent root canal cleaning and shaping. Before filling, the canals were randomly distributed into three groups according to the sealer to be used: Group 1 - AH Plus; Group 2 - Sealer 26; and Group 3 - Endofill (Dentsply, Indústria e Comércio Ltda.). Immediately after filling, the gutta percha and sealer were partially removed from the canals, leaving material only in the apical third of the root. The teeth were temporarily sealed with glass ionomer sealer for 72 h to ensure setting. The coronal seal was then removed and the canals were exposed to the oral cavity for 45 days. The animals were euthanased and their mandibles and maxillae were removed. After abundant irrigation with distilled water, the canals were dried and filled with India ink. The teeth were sealed again for 96 h before extraction. The roots of the extracted premolars were separated and stored in labelled test tubes. The roots were cleared and the extent of dye penetration was measured with a 20x stereoscopic magnifying lens. RESULTS: Statistical analysis revealed that there were significant differences between the sealers studied (P < 0.001). Means for the extent of dye penetration for AH Plus, Endofill and Sealer 26 were, respectively, 0.13, 2.27 and 3.08 mm. CONCLUSIONS: After 45 days exposure to the oral cavity, none of the sealers was capable of preventing leakage and coronal dye penetration. There were significant differences between the sealers studied, in terms of mean dye penetration.