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.     

葡萄糖定量法检测3种根管封闭剂的封闭性能

目的 :用葡萄糖定量法检测根管微渗漏的模型评价 3种根管封闭剂封闭根管的能力。方法 :选取 72颗直根管的上前牙 ,随机分为 3个试验组 (每组各 2 0例 )和 2个对照组 (阳性对照和阴性对照各 6例 ) ,用侧向加压充填技术充填根管 ,试验组所用根管封闭剂分别为PulpCanalSealerEWT、Sealapex和AHPlus,置于微渗漏模型 ,于第1、2、4、7、10、15、2 0、30天检测从冠方向根方漏出的葡萄糖的量 ,检测方法为葡萄糖氧化酶法。结果 :第 1、2、4、7天3种根管封闭剂的微渗漏值无显著性差异 (P >0 .0 5 ) ,从第 10天起 ,PulpCanalSealerEWT组的微渗漏明显高于AHPlus、Sealapex组 (P <0 .0 0 1) ,后 2种封闭剂的微渗漏无显著性差异 (P >0 .0 5 )。 结论 :根管封闭剂AHPlus、Sealapex封闭根管的能力好于PulpCanalSealerEWT。     

Tissue response to an epoxy resin-based root canal sealer

Abstract— Thc objective of the present study was to evaluate two different types of root canal sealers: AH Plus (an epoxy resin-based sealer) and Fill Canal (a zinc oxide-eugenol based sealer). A total of 34 root canals with vital pulp from dogs' premolars were used. After instrumentation, the root canals were filled with gutta-percha and AH Plus or gutta-percha and Fill Canal sealers using a classical technique of lateral condensation. After histological processing, the sections were stained with hematosylincosin or Mallory's trichrome stain. Inflammatory cells or areas of necrosis were not associated with AH Plus. Hard tissue formation apically to the material was observed in 14 specimens. The Fill Canal sealer presented an inflammatory response of moderate intensity in the periapical region, mainly adjacent to the material.     

Tissue response to an epoxy resin-based root canal sealer

The objective of the present study was to evaluate two different types of root canal sealers: AH Plus (an epoxy resin-based sealer) and Fill Canal (a zinc oxide-eugenol based sealer). A total of 34 root canals with vital pulp from dogs' premolars were used. After instrumentation, the root canals were filled with gutta-percha and AH Plus or gutta-percha and Fill Canal sealers using a classical technique of lateral condensation. After histological processing, the sections were stained with hematoxylineosin or Mallory's trichrome stain. Inflammatory cells or areas of necrosis were not associated with AH Plus. Hard tissue formation apically to the material was observed in 14 specimens. The Fill Canal sealer presented an inflammatory response of moderate intensity in the periapical region, mainly adjacent to the material.     

The apical sealing ability of a new root canal filling material

PURPOSE: To assess the apical sealing property of a new root canal filling material, Epiphany. METHODS: Seventy extracted maxillary and mandibular single-rooted teeth were used. They were randomly divided into three groups and obturated by lateral condensation with gutta-percha and AH 26/AH Plus sealers and Resilon core material and Epiphany sealer. Apical leakage was measured by the fluid-transport method. RESULTS: The differences in leakage among gutta-percha with AH 26, gutta-percha with AH Plus, and Resilon with Epiphany were statistically significant (P < 0.05). The teeth filled with gutta-percha/AH 26 displayed the most apical leakage. There were no differences between the Resilon/Epiphany and gutta-percha/AH Plus groups (P > 0.05).     

3种根管糊剂根尖封闭性能的评价

目的　体外评价iRoot SP、AH Plus、Vitapex 3种根管糊剂的根尖封闭能力。方法　 离体单根管恒牙45颗,随机分为3组,每组15颗;通过染色法微渗漏实验比较3种根管糊剂的根尖封闭能力,并通过扫描电镜观察根管壁与糊剂之间的结合特征。结果　 iRoot SP与AH Plus组的微渗漏值较小且两者无统计学差异,Vitapex糊剂组的微渗漏值最大,与其他两组有统计学差异(P<0.05)。扫描电镜下不同根管封闭剂与根管壁和牙胶间均观察到空隙存在。结论　 iRoot SP和AH Plus的根管封闭性能较Vitapex糊剂更佳。     

Bacterial and fungal microleakage of AH26 and AH Plus root canal sealers

AIM: To evaluate the penetration of Candida albicans alone and a combination of bacteria through root canals filled with gutta-percha and one or other root canal sealers, AH26 and AH Plus. METHODOLOGY: Eighty teeth were randomly divided into two groups of 40 teeth each and obturated with gutta-percha using either AH26 or AH Plus sealer. A further 10 teeth served as negative controls and 10 as positive controls. The external surface of each root, except the apical 2 mm, was covered with two layers of nail varnish. The teeth were inserted into Eppendorf plastic tubes and suspended in glass bottles containing sterile Schaedler broth. Streptococcus mutans, Streptococcus mitis, Prevotella melaninogenica and Lactobacillus acidophilus were placed in the access cavities of 20 teeth filled with AH26 and 20 with AH Plus. Candida albicans was placed in the access cavities of the other teeth. The culture medium with microorganisms was changed every 7 days. Every 72 h bacterial or fungal growth in the broth was tested up to a period of 90 days. RESULTS: Leakage in the experimental teeth occurred between 14 and 87 days. Leakage was present in 47% of all samples. From the samples with AH26, 45% leaked bacteria and 60% leaked fungi; whilst from the samples with AH Plus, 50% leaked bacteria and 55% fungi. There was no statistically significant difference in penetration of bacteria and fungi between the sealers. CONCLUSION: In this in vitro study, gutta-percha and the sealers AH26 and AH Plus allowed leakage of bacteria and fungi.     

Evaluation of apical sealing ability and adaptation to dentine of two resin-based sealers

The purpose of this study was to evaluate the apical sealing ability and adaptation to dentine of two resin-based root canal sealers. The root canals of 55 human maxillary anterior teeth were prepared using a step-back technique and the smear layer removed with 17% ethylenediaminetetraacetic acid. The teeth were divided into two groups of 25 teeth and the remaining five teeth served as control. Then the teeth were prepared and obturated with gutta-percha by a lateral condensation and either AH plus and EndoRez used as a sealer. Twenty teeth from each group were used for the apical leakage test and the remaining five teeth from each group were used for examination under the scanning electron microscope (SEM). For apical leakage test, teeth were covered with nail varnish and sticky wax to within 1 mm of the apical foramen and placed in 2% methylene blue for 7 days. After this period, the teeth were sectioned longitudinally and apical leakage measurements made. The mean value of dye penetration for AH plus was 2.87 +/- 0.43 mm, while that of EndoRez was 4.54 +/- 0.36 mm. The difference between mean of dye penetration was statistically significant (P < 0.01). The SEM examination showed both sealers had better adaptation and penetration in coronal and middle thirds than apical third of root canal. In apical third, AH plus was adapted better adpated to dentine than EndoRez. In conclusion, AH plus sealer has better apical sealing ability and adaptation to dentine than EndoRez sealer.     

Filling of artificial lateral canals and microleakage and flow of five endodontic sealers

AIM: To evaluate the flow characteristics of AH Plus, Epiphany Root Canal Sealant, Endométhasone, Pulp Canal Sealer (EWT) and Sealapex and their ability to fill artificial lateral canals and prevent microleakage. METHODOLOGY: Flow of the sealers was analysed using the American Dental Association (ADA) 57 and the International Standards Organization (ISO) 6,876 specifications. Two lateral canals were produced in the middle and apical third of 64 roots using 0.1 mm cylindrical drills. Lateral condensation of gutta-percha or Resilon and one or other of the sealers were used to fill the root canals. Buccal-lingual digital radiographs were exposed. After the sealer had set, the roots were immersed in Indian ink and cleared in methyl salicylate. The extent of filling and dye penetration were measured on the buccal and lingual root surfaces under 30 x magnification with a stereoscope. RESULTS: AH Plus, Epiphany and Pulp Canal Sealer (EWT) complied with ADA 57 and ISO 6,876 specifications. Sealapex complied with the ADA 57 specification but not with ISO 6,876. Endométhasone did not comply with either specification. Filling of lateral canals was similar for the five sealers tested. Dye leakage demonstrated that AH Plus, Epiphany and Sealapex permitted less leakage than Pulp Canal Sealer (EWT) (P < 0.05). CONCLUSIONS: All the sealers flowed into the 0.1 mm artificial lateral canals. AH Plus, Epiphany and Sealapex allowed less linear leakage than Pulp Canal Sealer (EWT). The flow of Endométhasone did not comply with either ADA 57 or ISO 6,876 specifications and Sealapex did not comply with ISO 6,876.     

Influence of moisture on the apical seal of root canal fillings with five different types of sealer

The aim of this study was to evaluate the influence of moisture on apical leakage using five different types of sealer. There were 120 single-rooted teeth instrumented to .02/#60 and randomly assigned to 10 experimental groups, one control group (AH Plus, lateral condensation) (n = 10) or positive/negative controls (n = 5). Before obturation teeth were dried thoroughly, followed by recontamination with moisture in a wet chamber (moist groups; 37 degrees C for 7 days). The teeth of the experimental groups (a, dry; b, moist) were obturated with sealer (groups 1, AH Plus; 2, Apexit; 3, Ketac-Endo; 4, RoekoSeal; 5, Tubli-Seal) and a single gutta-percha cone .02/#55. Teeth were centrifuged (30 x g for 3 minutes) in 5% methylene blue. Linear dye penetration was measured under a stereomicroscope. Moisture led to less microleakage for Apexit, RoekoSeal, and Tubli-Seal and higher values for AH Plus and Ketac-Endo. Multifactorial ANOVA displayed a significant dependence of leakage on sealer (p < 0.001) and the combination sealer or moisture (p < 0.01). It depends on the sealer type in which way moisture affects the apical seal.     

Leakage of five root canal sealers

AIM: The aim of this study was to examine the apical sealing ability of five root canal sealers using a fluid transport model. METHODOLOGY: A comparison of root canal scalers AH26, AH Plus, Diaket, Apexit, and Ketac-Endo were tested on 60 single-rooted teeth. The coronal part of each tooth was removed at the amelo-cemento junction, and also 3 mm of the root tip. Root canals were instrumented using the 'step-back' technique with Gates Glidden drills and irrigated with 2.5% NaOCl. The specimens were divided into five groups of 10 samples each and filled with test materials and gutta-percha points by the cold lateral condensation technique. Ten teeth were used as a control group, out of which five served as negative and five as positive controls. The leakage was measured by the movement of an air bubble in a capillary glass tube connected to the experimental root section. RESULTS: The differences in leakage amongst Ketac-Endo (0.318 microL: SD 0.084), AH26 (0.319 microL; SD 0.075), AH Plus (0.330L; SD 0.085) Apexit (0.360 microL; SD 0.127) and Diaket (0.387 microL; SD 0.140) were not statistically significant (P > 0.05). CONCLUSIONS: Under the conditions of this study, all five sealers produced a satisfactory seal.     

Reliability of the dye penetration studies

The purpose of this study was to compare the classical dye-penetration method to a dye-extraction method, with a fluid-filtration method as control. Forty teeth were prepared with a ProFile device and divided into four groups (n = 10 per group) according to the sealer used for the lateral condensation: Pulp Canal Sealer, Sealapex, AH Plus, and Ketac-Endo. The apical seal was evaluated on the same teeth with all three methods, successively: a fluid-filtration method, a dye-penetration method with 2% methylene blue, and a new method where the roots were dissolved in 65% nitric acid to extract the methylene blue before reading the absorbance of the solution. The classical dye penetration did not show any difference among the sealers and showed no correlation with the two other techniques. The fluid filtration (p < 0.01) and the dye extraction (p < 0.01) showed that Sealapex displayed the highest apical leakage. The correlation between the results obtained with these two methods was significant (p = 0.001 and r = 0.7). This study showed the limitation of the classical dye-penetration studies and that the dye-extraction, i.e. dissolution, method gave the same results as fluid filtration but saved much laboratory time.     

侧向加压和垂直加压充填技术的根管微渗漏

目的:用葡萄糖定量法检测根管微渗漏的模型,评价侧向加压充填技术和垂直加压充填技术封闭根管的能力。方法:选取 70颗直根管的上前牙,根管预备后随机分为对照组(阳性对照和阴性对照各 5颗)和A、B、C、D4个试验组,A、B组用侧向加压充填技术,C、D组用垂直加压充填技术充填根管,A、C组的封闭剂为AHPlus,B、D组为PulpCanalSealerEWT。于第 1、2、4、7、10、15、20、30天用葡萄糖氧化酶法检测从冠方向根方漏出的葡萄糖的量。结果:第 1、2、4天 4组微渗漏值无显著性差异(P>0. 05), A组和B组第 20、30天,B组和D组第 15、20、30天有显著性差异(P< 0. 05);从第 4天起,垂直加压充填技术的微渗漏小于侧向加压充填技术(P<0. 05)。当用侧向加压技术充填根管时,AHPlus的微渗漏小于PulpCanalSealerEWT,用垂直加压技术充填根管时, 2种封闭剂的微渗漏值无显著性差异。结论:垂直加压充填技术封闭根管的能力优于侧向加压充填技术。     

A new quantitative method using glucose for analysis of endodontic leakage

OBJECTIVE: The purpose of this study was to introduce a new method for quantitative testing of endodontic leakage. STUDY DESIGN: Eighty straight maxillary anterior teeth were divided randomly into 3 experimental groups of 20 samples each and 2 control groups. The experimental groups were prepared using the modified double-flared technique and obturated by lateral compaction of cold gutta-percha with Pulp Canal Sealer EWT, Sealapex, or AH Plus sealer. With the leakage test device, coronal 1 mol/L glucose solution was forced under a hydrostatic pressure of 1.5 kPa toward the apical part of the root. Leakage was measured by the concentration of leaked glucose in apical reservoir at 1, 2, 4, 7, 10, 15, 20, and 30 days with the enzymatic glucose oxidase method. RESULTS: No significant difference of sealing ability was found among 3 test groups at 1, 2, 4, and 7 days. From the tenth day, Pulp Canal Sealer EWT showed the highest leakage, and the leakage was not significantly different between Sealapex and AH Plus. CONCLUSIONS: The quantitative method is sensitive, nondestructive, and clinically relevant. Pulp Canal Sealer EWT showed more leakage than Sealapex and AH Plus in most observation time.     

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.     

Sealing properties of a new epoxy resin-based root-canal sealer

In this study a new epoxy-resin-based endodontic sealer, AH Plus, was tested in vitro for apical leakage. The conventional sealer AH26, for which information is already available, was used as the control. The root canals of 72 single-rooted teeth were prepared biomechanically using a stepback technique before lateral condensation of gutta-percha with one of the two sealers. Teeth were immersed in 5% methylene blue dye for 2, 4 or 10 days. The roots were split longitudinally so that the extent of dye penetration could be measured with a stereomicroscope. The mean extent at 2 days was 0.4 mm for AH26 and 1.4 mm for AH Plus. Neither material produced a complete apical seal and leakage increased with the duration of immersion in dye. The differences between observation periods as well as between materials with respect to dye penetration were statistically significant ANOVA , ( P < 0.005).     

Apical leakage of four endodontic sealers

The purpose of this study was to evaluate the sealing properties of four root canal sealers. Forty-eight maxillary central incisors were instrumented with Profile rotary instruments. They were randomly divided into four groups (n = 12) and filled using lateral condensation with one of the four sealers: Sealapex, Pulp Canal Sealer, AH 26, and Ketac-Endo. The apical leakage was measured with a fluid filtration method and expressed as L s(-1) KPa(-1). The teeth filled with Sealapex displayed a higher apical leakage (8.42 +/- 4.2 10(-11) L s(-1) KPa(-1)) than those filled with AH 26 (2.10 +/- 1.39 10(-11) L s(-1) KPa(-1)), Pulp Canal Sealer (0.17 +/- 0.09 10(-11) L s(-1) KPa(-1)) or Ketac-Endo (0.32 +/- 0.24 10(-1) L s(-1) KPa(-1)) (p < 0.01). No statistically significant difference was found among AH 26, Pulp Canal Sealer, and Ketac-Endo. No correlation was found between the sealing efficiency of the four sealers and their adhesive properties recorded in a previous study.     

A quantitative evaluation of apical leakage of four root-canal sealers

AIM: This in vitro study evaluated the microleakage of root fillings involving four root-canal sealers including AH Plus (De-Trey, Switzerland), RoekoSeal (Roeko, Germany). Ketac-Endo (ESPE, (Germany) and Sultan (Sultan Chemists, USA. METHODOLOGY: Forty extracted human maxillary anterior teeth were used. The coronal part of each tooth was removed and the root canals were prepared using the step-back technique and apical enlargement to size 60 file. The specimens were randomly divided into four groups of 10 samples, filled with one of the test materials and gutta-percha cones by the cold lateral condensation technique. A fluid filtration method was used for quantitative evaluation of apical leakage. The leakage was measured by the movement of an air bubble in a capillary glass tube connected to the experimental root section. Measurements of fluid movement were made at 2-min intervals for 8 min. Water transport through existing voids in the obturated canals could be measured reproducibly in this way. The quality of the seal of each specimen was measured after 7,14 and 21 days. RESULTS: Statistical analysis indicated that all the root fillings showed less leakage after 21 days (P < 0.05). Fillings incorporating Sultan showed significantly more leakage than all other sealers. CONCLUSIONS: Root fillings with RoekoSeal in combination with cold lateral condensation technique showed better sealing than those with Ketac-Endo, AH Plus and Sultan sealers after 21 days. The fluid filtration test used in this study gave quantitative results and allowed nondestructive long-term evaluation of specimens.     

Influence of root canal dressings and sealers on repair of apical periodontitis after endodontic treatment

OBJECTIVE: The objective of this study was to evaluate the histopathologic response of periapical tissues after root canal treatment of necrotic dog teeth with chronic apical periodontitis by using 2 calcium hydroxide-based root canal dressings and 2 root canal sealers. STUDY DESIGN: Seventy-eight root canals were instrumented by using 5.25% sodium hypochlorite as the irrigating solution, after which a calcium hydroxide paste (Calen/PMCC or Calasept) was placed for 30 days as a dressing. The root canals were then filled by using cold lateral gutta-percha condensation and an endodontic sealer (Sealapex or AH Plus). After 360 days, the animals were killed by anesthetic overdose; then, the teeth were histologically prepared, sectioned, and stained with hematoxylin and eosin for optical microscopic analysis of apical and periapical tissue repair. RESULTS: Statistical analysis showed that the poorest histopathologic results were observed in the Calasept/AH Plus group and that the Sealapex sealer overall resulted in better apical repair than the AH Plus sealer. The histopathologic results of Calen/PMCC paste with both AH Plus and Sealapex and Calasept paste with only Sealapex were statistically similar but were different from the results of Calasept with AH Plus. CONCLUSIONS: The results of this study in the dog showed differences in apical and periapical tissue repair of teeth with chronic apical periodontitis by using 2 calcium hydroxide root canal dressings and 2 sealers. More research is necessary to determine the best combination of dressings and sealers.     

An in vitro study of apical and coronal microleakage of laterally condensed gutta percha with Ketac-Endo and AH-26

The purpose of this in vitro study was to compare both apical and coronal dye penetration when Ketac-Endo and AH-26 sealers were user with laterally condensed gutta percha. Crowns were removed from 28 teeth and the root canals were biomechanically prepared. The teeth were divided into two groups of 12 teeth. each and a control group of 4 teeth. Root canals in the two experimental groups were filled with laterally condensed gutta percha and either Ketac-Endo or AH-26 sealer. The ketac-Endo group had the coronal 3 mm of gutta percha and sealer removed and the resultant cavity was filled with Ketc-Endo alone. After the sealers had set, the root surfaces were coated with nail varnish except at the apex and at the coronal end. Positive control had no root fillings and were coated with nail varnish in the same manner while the negative controls were sealed apically and coronally with Cavit prior to apically and coronally with Cavit prior to sealing the entire external root surface with nail varnish. Specimens were placed in 2% methylene blue dye in a vacuum of 660 mm of mercury for five minutes and than left immersed for a further two days. The roots were vertically sectioned to determine the following mean levels of dye penetration: keta-Endo, 1.08 mm apically and 6.29 mm coronally; AH-26, 0.75 mm apically and 6.67 mm coronally. Positive controls had total leakage and negative controlls had no leakage. This study demonstrated that the apical and coronal seals obtained with Ketac-Endo and AH-26 were not significantly different although the apical seal obtained with each material was significantly better than the corresponding coronal seal.