Debunking the Concept of Dentinal Tubule Penetration of Endodontic Sealers: Sealer Staining with Rhodamine B Fluorescent Dye Is an Inadequate Method

The aim of this study was to investigate the suitability of rhodamine B dye staining of an epoxy resin sealer (AH Plus) and calcium-silicate-based sealers (Total Fill BC Sealer, BioRoot RCS) to represent the penetration depth of the sealers into dentinal tubules after root canal obturation. In a three-step process, (1) leaching of rhodamine B from sealers into a buffer solution, (2) passive penetration of leached rhodamine B into dentinal tubules, and (3) conformity of rhodamine B penetration assessed by confocal laser scanning microscopy (CLSM), and sealer penetration assessed by scanning electron microscopy (SEM), in root-canal-filled teeth, were evaluated. Rhodamine B dye massively leached out of Total Fill BC Sealer and BioRoot RCS into the phosphate-buffered saline (PBS). A pinkish coloration of AH Plus was found after contact with PBS. Leached rhodamine B dye passively penetrated dentinal tubules from all three sealers when placed on root dentin. No correlation was observed between sealer penetration in SEM and rhodamine B penetration in CLSM. Staining of sealers using rhodamine B is an inadequate method with which to evaluate sealer penetration depth into dentinal tubules, as it overestimates the penetration of sealers into root dentin tubules.     

Calcium Silicate-Based Root Canal Sealers: A Narrative Review and Clinical Perspectives

Over the last two decades, calcium silicate-based materials have grown in popularity. As root canal sealers, these formulations have been extensively investigated and compared with conventional sealers, such as zinc oxide–eugenol and epoxy resin-based sealers, in in vitro studies that showed their promising properties, especially their biocompatibility, antimicrobial properties, and certain bioactivity. However, the consequence of their higher solubility is a matter of debate and still needs to be clarified, because it may affect their long-term sealing ability. Unlike conventional sealers, those sealers are hydraulic, and their setting is conditioned by the presence of humidity. Current evidence reveals that the properties of calcium silicate-based sealers vary depending on their formulation. To date, only a few short-term investigations addressed the clinical outcome of calcium silicate-based root canal sealers. Their use has been showed to be mainly based on practitioners’ clinical habits rather than manufacturers’ recommendations or available evidence. However, their particular behavior implies modifications of the clinical protocol used for conventional sealers. This narrative review aimed to discuss the properties of calcium silicate-based sealers and their clinical implications, and to propose rational indications for these sealers based on the current knowledge.     

Pilot Evaluation of Sealer-Based Root Canal Obturation Using Epoxy-Resin-Based and Calcium-Silicate-Based Sealers: A Randomized Clinical Trial

The purpose of this randomized controlled clinical trial was to assess the short-term clinical effectiveness of sealer-based root canal obturation using calcium-silicate-based sealer (CSBS) and epoxy-resin-based sealer (ERBS). A total of eighty patients (eighty teeth) were enrolled and seventy-two patients (seventy-two teeth) were randomly assigned into four different sealer groups: AH Plus (AH, Dentsply Sirona), ADseal (AD, Meta Biomed), CeraSeal (CS, Meta Biomed), or EndoSeal TCS (ES, Maruchi). At the first visit, root canal treatment was performed using ProTaper. Next, the NiTi file system and passive ultrasonic irritation was applied with 2.5% NaOCl. At the second visit, the teeth were obturated with a sealer-based obturation technique using the assigned sealer. The quality of filling obturation was evaluated with postoperative radiographs in terms of the presence of voids and sealer extrusion. The patients were recalled at 1-week, 1-month, and 3-month intervals, and pain levels were measured using visual analog scales (VAS), and clinical examination performed with percussion and palpation. Radiographs were also taken. The results were statistically compared by using the χ² test or Fisher exact test. Among the 80 teeth included, 72 teeth received allocated intervention and 71 teeth were included in the analysis (98.6% recall). There was no significant difference among the sealers in void and sealer extrusion (p > 0.05). Postoperative pain was not indicated prominently regardless of the type of sealer. For a 3-month follow-up period, all cases were maintained successfully except for one case from AD. According to the findings, there was no significant difference between CSBS and ERBS in terms of postoperative pain or the healing process, and the variation in filling quality appears to be linked to the properties of each product.     

Assessment of Bioceramic Sealer Retreatability and Its Influence on Force and Torque Generation

This study assesses the retreatability of TotalFill bioceramic (TFBC) and AH Plus (AHP) sealers and their impact on retreatment force and torque. Twenty-six premolar teeth with single oval canals were instrumented, obturated using the matched gutta-percha cone technique with one of the tested sealers, and then temporized. After a 6-month incubation at 37 °C and 100% humidity, the canals were retreated with the XP Shaper system. During retreatment, the generated force and torque were measured. Micro-CT scanning was run before and after the retreatment procedure to analyze the remaining obturating materials in the canals. The apically directed maximum force in AHP was higher than that in TFBC. The coronally directed maximum force and the maximum torque were comparable between the groups. A higher amount of remaining obturating materials was found in the AHP compared to that in the TFBC. Based on these findings, endodontic sealer had an influence on retreatability, and the TFBC showed less remaining obturating materials and lower retreatment forces in the apical direction compared to the AHP in extracted teeth with oval canals.     

Comparison of Obturation Quality between Calcium Silicate-Based Sealers and Resin-Based Sealers for Endodontic Re-treatment

Background: The objective of this micro-computed tomography (micro-CT)-based study was to compare the filling quality of endodontic treatment and endodontic Re-treatment between two sealers with matched obturation techniques: calcium silicate-based sealer (Endoseal TCS) with a single-cone technique (SCT) and resin-based sealer (AH Plus) with a continuous wave technique (CWT). Methods: Forty maxillary premolars were selected and assigned into four groups, according to the obturation methods of the first endodontic treatment and Re-treatment (n = 10). The AP/AP group was first treated with AH Plus/CWT, then re-treated with AH Plus/CWT. The AP/ET group was first treated with AH Plus/CWT, then re-treated with Endoseal TCS/SCT. The ET/AP group was first treated with Endoseal TCS/SCT, then re-treated with AH Plus/CWT, and the ET/ET group was first treated with Endoseal TCS/SCT, then re-treated with Endoseal TCS/SCT. The specimens were scanned using micro-CT at three time points: after the first endodontic treatment, after gutta-percha (GP) cone removal, and after Re-treatment. The void volume of root canal obturation and the volume of the remaining filling materials were calculated. Data were analyzed using Student’s t-tests and ANOVA. Results: The Endoseal TCS groups (ET/AP and ET/ET) showed a lower percentage of voids than the AH plus groups (AP/AP and AP/ET) on the whole canal and the apical third, after first obturation (p < 0.05). The AH plus group showed significantly fewer remnants than the Endoseal TCS group after GP removal (p < 0.05). Re-treated canals and initially treated canals had similar void volumes (p > 0.05). There was no significant difference in void volume after Re-treatment, regardless of whether the same or different sealers were used for the first treatment and Re-treatment (p < 0.05). Conclusions: Endoseal TCS sealer and AH Plus sealer had a similar Re-treatment efficacy, regardless of which sealer was used in the previous treatment.     

Physico-Chemical Properties of Calcium-Silicate vs. Resin Based Sealers—A Systematic Review and Meta-Analysis of Laboratory-Based Studies

Introduction: The aim of this systematic review is to analyse the effect of physico-chemical properties of calcium silicate-based sealers in comparison to epoxy resin sealers in permanent teeth using a single-cone obturation technique. Methods: The study was conducted according to the guidelines of Cochrane Handbook for Systematic Reviews of Interventions and Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Literature search was performed using the PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, DOAJ, Open Gray with no language restrictions until October 2020. Two reviewers assessed the studies for eligibility. Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was carried out to assess the evidence. Meta-analysis of the pooled data with subgroups was performed using the RevMan software (p < 0.05). Results: Results from the 28 included studies showed that the mean difference in adaptation to root canal walls (marginal adaptation, interfacial gaps and void volume) for both sealers were non-significant. However, void volume values showed a significant mean difference (p < 0.00001) favouring the calcium silicate-based sealers. The pooled meta-analysis reported statistically significant differences for apical microleakage (p = 0.0007) whilst there were non-significant mean differences for fracture resistance (p = 0.09) and push-out bond strength (p = 0.63). The heterogeneity among the included studies was 97% (I²). Conclusions: Within the limitations of this review, calcium silicate-based sealers demonstrated a similar or superior performance in comparison to resin-based sealers in terms of the physico-chemical properties.     

Efficacy of Reciprocating Instruments in the Removal of Bioceramic and Epoxy Resin-Based Sealers: Micro-CT Analysis

The objective of this study was to evaluate the efficacy of reciprocating instruments in the removal of bioceramic and epoxy resin-based sealers using micro-CT analysis. Root canals of 40 extracted human teeth were instrumented with a size R25 Reciproc instrument. Specimens were randomly divided into two groups (n = 20) according to the root canal filling material. In the first group, root canals were obturated with AH Plus sealer and Reciproc R25 gutta-percha. In the second group, a combination of bioceramic gutta-percha (TotalFill BC) and bioceramic sealer (TotalFill BC) was used. After one week, the retreatment of all specimens was performed using Reciproc instruments. To analyze the differences in the filling remnants, specimens were scanned in a micro-CT device after obturation and after the retreatment procedure. Statistical analysis was performed using the Mann–Whitney U test (p < 0.05). A combination of bioceramic sealer and bioceramic gutta-percha was more effectively removed from canals using a reciprocating instrument, with a filling remnants volume of 4.01 ± 3.13 mm³, in comparison to the combination of epoxy resin-based sealer and gutta-percha (6.96 ± 2.70 mm³) (p < 0.05). A reciprocating instrument was more effective in removing bioceramic sealers than epoxy resin-based sealers, although none of the root canal filling materials were completely removed from the root canals.     

Characterization,Antimicrobial Effects,and Cytocompatibility of a Root Canal Sealer Produced by Pozzolan Reaction between Calcium Hydroxide and Silica

This study aimed to evaluate a newly developed pozzolan-based bioceramic sealer (PZBS) regarding setting time, radiopacity, antibacterial effect, and cytocompatibility. The PZBS was manufactured by mixing calcium hydroxide and silica. The pozzolan reaction was verified by identification of calcium silicate hydrate (C-S-H) using X-ray diffraction analysis. The initial setting time and radiopacity were measured using the ISO 6876/2012 protocol in comparison with other commercially available calcium silicate (CS) sealers. The antibacterial effect of PZBS on biofilms cultured in the bovine root canal was evaluated by measurement of colony-forming units and volume of biofilms in comparison with other calcium hydroxide pastes. The morphological features of the biofilms were observed by scanning electron microscopy (SEM). The cytocompatibility of PZBS was assessed by the viability of bone marrow–derived mesenchymal stem cells and scratch wound healing rate in comparison with other CS sealers. The morphology of the cells cultured on the tested sealers was observed by SEM. The detection of the CS peak confirmed the formation of C-S-H. The initial setting time of PZBS was around 11 h, which was twice as long as the other tested sealers. The radiopacity of PZBS was 4.3 mm/Al, which satisfied the ISO criteria. The antibacterial effect and cytocompatibility of PZBS were comparable to those of the commercially available intracanal medicaments and CS endodontic sealers, respectively. The PZBS has the potential to be used for root canal obturation, and is expected to exert a favorable antibacterial effect.     

Characterization of Bioactive Colored Materials Produced from Bacterial Cellulose and Bacterial Pigments

A Bacterial Cellulose (BC) film was developed and characterized as a potential functional bioactive material. BC films, obtained from a microbial consortium of bacteria and yeast species, were functionalized with the bacterial pigment prodigiosin, produced by Serratia plymuthica, and flexirubin-type pigment, from Chryseobacterium shigense, which exhibit a wide range of biological properties. BC was successfully functionalized at 15% over the weight of the fiber at 40 °C during 60 min, and a color strength of 1.00 ± 0.01 was obtained for BC_prodigiosin and 0.38 ± 0.02 for BC_flexirubin-type pigment. Moreover, the BC films showed moderate hydrophilic character following alkaline treatment, which was maintained after both pigments were incorporated. The porosity and mechanical performance of the functionalized BC samples also remained unaffected. Furthermore, the BC samples functionalized with prodigiosin presented antibacterial activity and were able to inhibit the growth of pathogenic bacteria Staphylococcus aureus and Pseudomonas aeruginosa, with inhibition rates of 97.89 ± 0.60% and 85.12 ± 0.17%, respectively, while BC samples functionalized with flexirubin-type pigment exhibited the highest antioxidant activity, at 38.96 ± 0.49%. This research provides an eco-friendly approach to grant BC film-based material with color and advantageous bioactive properties, which can find application in several fields, especially for medical purposes.     

Effect of Heat Treatment on the Physical Properties of Provisional Crowns during Polymerization: An in Vitro Study

This study concerned the effect of heat treatment during setting on the physical properties of four resin-based provisional restorative materials: Duralay (polymethyl methacrylate), Trim II (polyethyl methacrylate), Luxatemp (bis-acrylic composite), and Protemp 4 (bis-acrylic composite). Specimens were prepared at 23, 37, or 60 °C for evaluation of flexural strength, surface roughness, color change and marginal discrepancy. Flexural strength was determined by a three-point bending test. Surface profile was studied using atomic force microscopy. Color change was evaluated by comparing the color of the materials before and after placement in coffee. A travelling microscope helped prepare standardized crowns for assessment of marginal discrepancy. Flexural strength of all tested materials cured at 23 °C or 37 °C did not significantly change. The surface roughness and marginal discrepancy of the materials increased at 60 °C curing temperature. Marginal discrepancies, color stability, and other physical properties of materials cured at 23 °C or 37 °C did not significantly change. Flexural strength of certain provisional materials cured at 60 °C increased, but there was also an increase in surface roughness and marginal discrepancy.     

Comparative Evaluation of Mineral Trioxide Aggregate Obturation Using Four Different Techniques—A Laboratory Study

This study aimed to compare the density of mineral trioxide aggregate (MTA) as a root canal filling material in the apical 5 mm of artificial root canals. Forty transparent acrylic blocks with 30-degree curved canals were instrumented and allocated into four compaction technique groups (n = 10): Lawaty (hand files); gutta-percha (GP) points; auger (nickel–titanium rotary files in reverse mode); and plugger technique. Filled canals were weighed after setting the MTA to calculate difference in mass. Two postoperative radiographs compared radiopacity by measuring luminance variations at 0.5 mm, 1 mm, 2 mm, 3 mm, 4 mm, and 5 mm from the root apex. Obturation time was measured using a digital chronometer. The significance level was set to p < 0.05. The plugger group had a lower mass. Relative luminance was significantly higher for the Lawaty group than the plugger group at all examined apical levels. The relative luminance of the auger and GP groups were significantly higher than the plugger group at depths between 0.5 mm and 2 mm. Relative luminance was highest for the Lawaty technique at all depths between 0.5 mm and 4 mm. The Lawaty technique group was associated with increased obturation time compared with pluggers. Compacting MTA in curved canals with the Lawaty technique has the highest mass and radiopacity but requires more time.     

Effect of Accelerated Aging on Some Mechanical Properties and Wear of Different Commercial Dental Resin Composites

The aim of current in vitro research was to determine the effect of hydrothermal accelerated aging on the mechanical properties and wear of different commercial dental resin composites (RCs). In addition, the effect of expiration date of the composite prior its use was also evaluated. Five commercially available RCs were studied: Conventional RCs (Filtek Supreme XTE, G-aenial Posterior, Denfil, and >3y expired Supreme XTE), bulk-fill RC (Filtek Bulk Fill), and short fiber-reinforced RC (everX Posterior). Three-point flexural test was used for determination of ultimate flexural strength (n = 8). A vickers indenter was used for testing surface microhardness. A wear test was conducted with 15,000 chewing cycles using a dual-axis chewing simulator. Wear pattern was analyzed by a three-dimensional (3D) noncontact optical profilometer. Degree of C=C bond conversion of monomers was determined by FTIR-spectrometry. The specimens were either dry stored for 48 h (37 °C) or boiled (100 °C) for 16 h before testing. Scanning electron microscopy (SEM) was used to evaluate the microstructure of each material. Data were analyzed using ANOVA (p = 0.05). Hydrothermal aging had no significant effects on the surface wear and microhardness of tested RCs (p > 0.05). While flexural strength significantly decreased after aging (p < 0.05), except for G-aenial Posterior, which showed no differences. The lowest average wear depth was found for Filtek Bulk Fill (29 µm) (p < 0.05), while everX Posterior and Denfil showed the highest wear depth values (40, 39 µm) in both conditions. Passing the expiration date for 40 months did not affect the flexural strength and wear of tested RC. SEM demonstrated a significant number of small pits on Denfil’s surface after aging. It was concluded that the effect of accelerated aging may have caused certain weakening of the RC of some brands, whereas no effect was found with one brand of RC. Thus, the accelerated aging appeared to be more dependent on material and tested material property.     

Trigger factor is induced upon cold shock and enhances viability of Escherichia coli at low temperatures

Trigger factor (TF) in Escherichia coli is a molecular chaperone with remarkable properties: it has prolyl-isomerase activity, associates with nascent polypeptides on ribosomes, binds to GroEL, enhances GroEL’s affinity for unfolded proteins, and promotes degradation of certain polypeptides. Because the latter effects appeared larger at 20°C, we studied the influence of temperature on TF expression. Unlike most chaperones (e.g., GroEL), which are heat-shock proteins (hsps), TF levels increased progressively as growth temperature decreased from 42°C to 16°C and even rose in cells stored at 4°C. Upon temperature downshift from 37°C to 10°C or exposure to chloramphenicol, TF synthesis was induced, like that of many cold-shock proteins. We therefore tested if TF expression might be important for viability at low temperatures. When stored at 4°C, E. coli lose viability at exponential rates. Cells with reduced TF content die faster, while cells overexpressing TF showed greater viability. Although TF overproduction protected against cold, it reduced viability at 50°C, while TF deficiency enhanced viability at this temperature. By contrast, overproduction of GroEL/ES, or hsps generally, while protective against high temperatures, reduced viability at 4°C, which may explain why expression of hsps is suppressed in the cold. Thus, TF represents an example of an E. coli protein which protects cells against low temperatures. Moreover, the differential induction of TF at low temperatures and hsps at high temperatures appears to provide selective protection against these opposite thermal extremes.     

Micro-Computed Tomographic Assessment of Microcrack Formation before and after Instrumentation of Curved Root Canals with Neoniti Rotary Files

The aim of this study was to assess the microcrack formation of moderately and severely curved root canals following instrumentation with Neoniti rotary files using micro-computed tomography. This in vitro study evaluated 18 extracted sound mandibular molars with two separate mesial canals and foramina in two groups (n = 9) with 5–20° (moderate) and 20–40° (severe) root canal curvature. The number of microcracks in the root canal walls was counted at baseline by micro-CT. Subsequently, the root canals were instrumented with 0.20/0.06 v Neoniti files as single files with a torque of 1.5 Ncm and a speed of 400 rpm. The number of microcracks was counted again postoperatively on micro-CT images using Amira software. Statistical analysis was performed using the Shapiro–Wilk test, Levene’s test and repeated-measures ANOVA (α = 0.05). The mean number of microcracks significantly increased postoperatively in both the moderately curved (11.59 ± 9.74 vs. 8.2 ± 7.4; p = 0.001) and the severely curved (13.23 ± 5.64 vs. 7.20 ± 5.94; p < 0.001) groups. However, the differences between the two groups were not significant (p = 0.668). Based on the results obtained, it can be stated that the instrumentation of moderately and severely curved root canals with Neoniti rotary files increases the number of microcracks. However, the higher degree of curvature does not necessarily translate to a higher number of microcracks after root canal instrumentation with this specific rotary system and methodological procedures.     

A Comparative Study of the Sintering Behavior of Pure and Manganese-Substituted Hydroxyapatite

Hydroxyapatite (HA) is a widely studied biomaterial for its similar chemical composition to bone and its osteoconductive properties. The crystal structure of HA is flexible, allowing for a wide range of substitutions which can alter bioactivity, biodegradation, and mechanical properties of the substituted apatite. The thermal stability of a substituted apatite is an indication of its biodegradation in vivo. In this study, we investigated the thermal stability and mechanical properties of manganese-substituted hydroxyapatite (MnHA) as it is reported that manganese can enhance cell attachment compared to pure HA. Pure HA and MnHA pellets were sintered over the following temperature ranges: 900 to 1300 °C and 700 to 1300 °C respectively. The sintered pellets were characterized via density measurements, mechanical testing, X-ray diffraction, and field emission electron microscopy. It was found that MnHA was less stable than HA decomposing around 800 °C compared to 1200 °C for HA. The flexural strength of MnHA was weaker than HA due to the decomposition of MnHA at a significantly lower temperature of 800 °C compared to 1100 °C for HA. The low thermal stability of MnHA suggests that a faster in vivo dissolution rate compared to pure HA is expected.     

Endodontic mishaps during root canal treatment performed by undergraduate dental students: An observational study

Endodontic mishaps during root canal treatment (RCT) are considered to be one of the most commonly encountered errors, which affect the quality of treatment and may have dangerous health implications for patients.The present study was conducted to assess the frequency and types of endodontic mishaps in root canal-treated teeth performed by undergraduate dental students.A total 404 endodontically treated teeth were performed by undergraduate dental students of King Khalid University College of Dentistry, Abha, Kingdom of Saudi Arabia. The radiographs of the endodontically treated teeth were studied for a period of 6 months, and the related demographic data were collected from patient files.The most commonly identified mishaps were related to obturation, where the maximum number of cases (68.1%) had under-obturated root canals. More endodontic mishaps were performed by students in level 9 education. The upper left 2nd molar teeth had a higher frequency of mishaps, and molars were found to have more access-related mishaps. Lastly, access-related and instrument-related mishaps had a low frequency of occurrence.The majority of endodontic mishaps found in the study sample were related to root canal obturation. The undergraduate students at level 9 were less proficient in conducting RCTs with many endodontic mishaps when compared to the cases performed by students at higher levels. The study suggests relevant guidance for dental students while performing RCTs, especially during obturation of the root canals.     

Apical Sealing Ability of Two Calcium Silicate-Based Sealers Using a Radioactive Isotope Method: An In Vitro Apexification Model

The aim of this study was to evaluate and compare the sealing ability of two calcium silicate-based sealers (TotalFill BC RRM Fast Set Putty and White ProRoot MTA) when used as apical plugs in immature teeth through nuclear medicine. Single-rooted extracted teeth (n = 34) had their crowns and root tip sectioned to obtain 14 mm long root segments to simulate an in vitro apexification model. Were created two experimental groups, namely MTA (n = 12) and BC (n = 12), and two control groups, PG (positive group, n = 5) and NG (negative group, n = 5). On the 4th day after placing the respective apical plug, the apical portions of the teeth were submerged in a solution of sodium pertechnetate (^99mTcNaO₄) for 3 h. Statistical analysis showed a significant difference between the MTA group and the controls (p < 0.05). The BC group had a significant difference regarding the negative control (p < 0.001) but showed no statistical significance regarding the positive control (p = 0.168). There was a statistically significant difference (p = 0.009) between the BC group (7335.8 ± 2755.5) and the MTA group (4059.1 ± 1231.1), where the last showed less infiltration. Within the limitations of this study, White ProRoot MTA had a significantly better sealing ability than TotalFill BC RRM Fast Set Putty.     

Industrial Thermal Insulation Properties above Sintering Temperatures

Processing highly flammable products, the oil and gas (O&G) industry can experience major explosions and fires, which may expose pressurized equipment to high thermal loads. In 2020, oil fires occurred at two Norwegian O&G processing plants. To reduce the escalation risk, passive fire protection may serve as a consequence-reducing barrier. For heat or cold conservation, equipment and piping often require thermal insulation, which may offer some fire protection. In the present study, a representative thermal insulation (certified up to 700 °C) was examined with respect to dimensional changes and thermal transport properties after heat treatment to temperatures in the range of 700 °C to 1200 °C. Post heat treatment, the thermal conductivity of each test specimen was recorded at ambient temperature and up to 700 °C, which was the upper limit for the applied measurement method. Based on thermal transport theory for porous and/or amorphous materials, the thermal conductivity at the heat treatment temperature above 700 °C was estimated by extrapolation. The dimensional changes due to, e.g., sintering, were also analyzed. Empirical equations describing the thermal conductivity, the dimensional changes and possible crack formation were developed. It should be noted that the thermal insulation degradation, especially at temperatures approaching 1200 °C, is massive. Thus, future numerical modeling may be difficult above 1150 °C, due to abrupt changes in properties as well as crack development and crack tortuosity. However, if the thermal insulation is protected by a thin layer of more robust material, e.g., passive fire protection to keep the thermal insulation at temperatures below 1100 °C, future modeling seems promising.     

Ball Milling Medium May Tune the Self-Curing Property and Root Canal Microleakage of β-Dicalcium Silicate-Based Cement

It is still a challenge to overcome the extended setting process of pure Ca-silicate as root canal fillers. We investigated the effects of attapulgite (a basic hydrous silicate of magnesium and aluminum) and ball-milling liquid medium on the self-curing properties of conventional β-dicalcium silicate (C2Si)-based cements. It was shown that a minor amount of attapulgite nanofibers (1–4%) had only a slight influence on setting time but caused a large increase in compressive resistance and structural stability. In particular, the ball milling media with different acetone/water ratios (3:0, 2:1, 1:2, 0:3) could directly influence the particle size distribution of C2Si powders, and the co-existence of liquid media (2:1 or 1:2) may be beneficial for shortening the setting time, enhancing early-stage compressive strength, and significantly improving the anti-microleakage ability of cement. Moreover, the composite cements also exhibited appreciable antibacterial efficacy in vitro. These findings demonstrated that the physicochemical properties of the Ca-silicate powders could be tuned by adding a minor amount of inorganic silicate nanofibers and a simple ball milling condition, and such a facile strategy is favorable for developing novel (pre-mixed) Ca silicate-based cements as root canal sealers.     

Comparison of Biocompatibility of Calcium Silicate-Based Sealers and Epoxy Resin-Based Sealer on Human Periodontal Ligament Stem Cells

The aim of this study was to evaluate the biocompatibility of calcium silicate-based sealers (CeraSeal and EndoSeal TCS) and epoxy resin-based sealer (AH-Plus) in terms of cell viability, inflammatory response, expression of mesenchymal phenotype, osteogenic potential, cell attachment, and morphology, of human periodontal ligament stem cells (hPDLSCs). hPDLSCs were acquired from the premolars (n = 4) of four subjects, whose ages extended from 16 to 24 years of age. Flow cytometry analysis showed stemness of hPDLSCs was maintained in all materials. In cell viability test, AH-Plus showed the lowest cell viability, and CeraSeal showed significantly higher cell viability than others. In ELISA test, AH-Plus showed higher expression of IL-6 and IL-8 than calcium silicate-based sealers. In an osteogenic potential test, AH-Plus showed a lower expression level than other material; however, EndoSeal TCS showed a better expression level than others. All experiments were repeated at least three times per cell line. Scanning electronic microscopy studies showed low degree of cell proliferation on AH-Plus, and high degree of cell proliferation on calcium silicate-based sealers. In this study, calcium silicate-based sealers appear to be more biocompatible and less cytotoxic than epoxy-resin based sealers.