Active versus passive microleakage of Resilon/Epiphany and gutta-percha/AH Plus

The purpose of this in vitro study was to assess the active versus passive dye microleakage and apical sealing ability of laterally condensed gutta-percha/AH Plus versus Resilon/Epiphany. One hundred and twenty teeth were instrumented and divided into experimental, positive and negative control groups. In group 1, the teeth were obturated with gutta-percha/AH Plus and in group 2 the teeth were obturated with Resilon/Epiphany. The apical seal was evaluated with a passive and active dye penetration test. Absorbance of the extracted dye was determined with a spectrophotometer. Resilon/Epiphany showed less dye penetration in comparison with the gutta-percha/AH Plus group (P < 0.05). There were no statistically significant differences between the passive and active dye penetration tests (P > 0.05). In this in vitro study, canals obturated with Resilon/Epiphany showed less apical leakage than those obturated with gutta-percha/AH Plus, regardless of the type of dye penetration test used.     

Push-out Bond Strength of Resilon/Epiphany and Resilon/Epiphany Self-Etch to Root Dentin

IntroductionThe present study was designed to investigate the bond strength produced by Epiphany and Epiphany SE to root canal dentin.MethodsA sample of 36 human upper canines was prepared and assigned to experimental groups (n = 12), designated as group 1, Resilon/Epiphany; group 2, Resilon/Epiphany SE; and group 3, AH Plus/gutta-percha. After the filling procedures, each tooth was prepared for push-out assessment by using root slices of 1-mm thickness. Loading was performed on a universal testing machine at a speed of 0.5 mm/min. One-way analysis of variance and Tukey test for multiple comparisons were used to compare the results among the experimental groups.ResultsAH Plus/gutta-percha root fillings showed significantly higher push-out bond strength than both Resilon/Epiphany and Resilon/Epiphany SE (P < .05). There was no significant difference between Epiphany/Resilon and Epiphany SE/Resilon (P > .05).ConclusionsUnder the present in vitro conditions, the adhesiveness quality to root dentin promoted by both Epiphany sealers is compromised even when teeth with simple anatomic features were obturated under well-monitored laboratory conditions.     

Influence of Drying Protocol with Isopropyl Alcohol on the Bond Strength of Resin-based Sealers to the Root Dentin

Introduction

This study compared the bond strength, interfacial ultrastructure, and tag penetration of resin-based sealers applied to smear-free radicular dentin using 70% isopropyl alcohol as the active final rinse.

Methods

Eighty root canals were prepared and assigned to 2 groups (n = 40) according to the drying protocol: paper points or 70% isopropyl alcohol. Then, roots were divided into 4 subgroups (n = 10) with respect to the sealer and obturation material: AH Plus (Dentsply De Trey GmbH, Konstanz, Germany) and gutta-percha (AH/GP), Hybrid Root SEAL (Sun Medical, Tokyo, Japan) and gutta-percha (HR/GP), Epiphany SE (Pentron Clinical Technologies, Wallingford, CT) and gutta-percha (EP/GP), and Epiphany SE and Resilon (EP/RS). Roots were sectioned, and the push-out test was performed. Failure modes were examined under stereomicroscopy and sealer penetration into the dentinal tubules under scanning electron microscopy. Data were statistically analyzed by 2-way analysis of variance post hoc Tukey tests with a significant level of 5%.

Results

Overall, canals dried with isopropyl alcohol showed significantly higher bond strength values (2.11 ± 1.74 MPa) than with paper points (1.81 ± 1.73 MPa) (P < .05). The HR/GP group showed lower bond strength than the AH/GP group (P < .05) but higher than the EP/GP and EP/RS groups (P < .05). The most frequent type of failure was cohesive in the AH/GP and HR/GP groups and adhesive in the EP/GP and EP/RS groups. Scanning electron microscopic evaluation revealed better adaptation of the adhesive interface in the AH/GP and HR/GP groups in comparison with the EP/GP and EP/RS groups.

Conclusions

A final rinse with EDTA and 70% isopropyl alcohol improved the bond strength and penetration of the sealers into dentinal tubules of the root.     

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).     

Evaluation of the quality of the apical seal in Resilon/Epiphany and Gutta-Percha/AH Plus-filled root canals by using a fluid filtration approach

This in vitro fluid filtration study compared the apical leakage of root canals that were obturated with Resilon/Epiphany (Resilon Research LLC, Madison, CT) or gutta-percha/AH Plus (GP/AH; DENTSPLY Tulsa, Tulsa, OK) sealer using warm vertical condensation. Fluid flow rate through the filled roots was measured 7 days after the obturations by using a fluid filtration device. Measurements were made before root resection and after 3 to 11 mm of resections. Before any removal of root length, there were no significant differences between the roots filled with Resilon/Epiphany or GP/AH. Analysis of individual root resection results revealed that differences in the fluid flow rate of the two systems occurred only when 9 or 10 mm of the roots were resected with more than half the root length resected when GP/AH Plus leaked more than Resilon/Epiphany. There were no significant differences in the fluid flow rate up to and including 8 mm of root resection. It is concluded Resilon/Epiphany sealed 17-mm root canals as well as gutta-percha and AH Plus sealer and that it does not create a monoblock root filling that does not leak.     

An in vitro assessment of the sealing ability of resilon/epiphany using fluid filtration

The aim of this in vitro study was to compare the sealing ability of Resilon/Epiphany to gutta-percha and Roth or AH Plus sealers. Leakage of the obturated roots was measured using the fluid filtration technique. There were eight groups of 12 teeth each. Group 1: obturated with Resilon/Epiphany; group 2: obturated with gutta-percha/Roth, allowed to set for 3 wk; group 3: obturated with gutta-percha/Roth; group 4: obturated with Resilon/Epiphany using a single cone; group 5: obturated with Resilon cones without using primer/sealer (positive control); group 6: obturated with gutta-percha/AH Plus; group 7: same as group 6, but allowed to set for 8 h; and group 8: sealed on the outside with three layers of nail varnish (negative control). The results showed that only the positive control (group 5) leaked significantly more (p < 0.05) than the other groups. There was no effect of time on leakage. Resilon/Epiphany was no better than gutta-percha/Roth or gutta-percha/AH Plus at sealing root canals.     

The influence of obturation technique on sealer thickness and depth of sealer penetration into dentinal tubules evaluated by computer-aided digital analysis

The aim of this study was to determine sealer penetration into dentinal tubules and sealer thickness with different obturation materials and techniques, with the null hypothesis that sealer cement thickness and dentinal tubule penetration was not affected by obturation technique. This study used 180 freshly extracted human mandibular premolars. Samples were obturated using the lateral condensation technique with either gutta-percha (Group 1) or Resilon (Group 2), using AH Plus (subgroup A) or Epiphany (subgroup B) as a sealer. Other samples were obturated with One-Step Obturator (Group 3) using AH Plus or Epiphany sealer. The sealer thickness and sealer penetration into dentinal tubules was evaluated using stereomicroscopy and analysis of digital images using AutoCAD software at 5.0 mm, 3.0 mm, and 1.0 mm from the apex. The mean value of sealer thickness for Group 3 was significantly lower than the mean values of the other groups. There was no significant difference in the mean values between subgroups A and B for Group 1 or Group 3, whereas for Group 2, the mean value in subgroup A was significantly higher than the mean value in subgroup B. The greatest average frequency of the penetration of sealer cement was found at the 5.0 mm level, followed by the 3.0 mm level, which, in turn, was greater than at the 1.0 mm level. The thickness of the sealer cement is dependent on the obturation technique employed, while the penetration of the sealer into the dentinal tubules is independent of the obturation technique.     

An in vitro evaluation of the apical sealing ability of a new resin-based root canal obturation system

The purpose of this study was to assess the apical sealing ability of the new resin-based Epiphany-Resilon root canal filling system, and to compare this with the sealing abilities of different pairings of AH plus, gutta-percha, Epiphany, and Resilon. Seventy extracted human single-rooted teeth were used. All teeth were instrumented using a set of ProTaper rotary instruments. The canal spaces were filled with different combinations of core and sealer using lateral condensation, as follows: group 1, AH Plus + gutta-percha; group 2, AH Plus + Resilon; group 3, Epiphany + Resilon; group 4, Epiphany + gutta-percha. Apical leakage quantity was measured with the computerized fluid filtration meter. Statistical analysis indicated that Epiphany gutta-percha combination had the least amount of microleakage than all the other groups; AH Plus gutta-percha combination proved to have second least amount of microleakage among the groups. AH Plus-Resilon combination demonstrated the greatest amount of microleakage. There were a significant difference between Epiphany gutta-percha and AH Plus-Resilon combinations (p < 0.05). It was found that there were no significant differences between Epiphany-Resilon combination and all the other groups (p > 0.05).     

Influence of endodontic irrigants on resin sealer bond strength to radicular dentin

The present study evaluated the influence of 2% chlorhexidine and 2.5% sodium hypochlorite on the resin sealer/dentin interface bond strength of AH Plus/gutta-percha and Epiphany/Resilon. Seventy-two extracted bovine incisors were randomly distributed into 6 groups according to irrigant and sealers: G(S+AH)=physiologic saline solution+AH Plus/gutta-percha; G(S+Ep)=physiologic saline solution+Epiphany/Resilon; G(H+AH)=2.5% sodium hypochlorite (NaOCl)+AH Plus/gutta-percha; G(H+Ep)=2.5% NaOCl+Epiphany/Resilon; G(C+AH)=2% chlorhexidine (CHX)+AH Plus/gutta-percha; and G(C+Ep)=2% CHX+Epiphany/Resilon. After 7 days at 37°C and 100% humidity, the roots were cut transversally on the long axis of the tooth in 0.8 mm (±0.09)-thick slices; these slices were then subjected to the push-out test. Data were analyzed using a 2-way ANOVA and Tukey tests at 5% significance. The AH Plus/gutta-percha groups showed significantly higher bond strength than the Epiphany/Resilon groups, regardless of the irrigant used (p<0.001). Sodium hypochlorite adversely affected bond strength in the AH Plus group, whereas chlorhexidine did not influence the push-out bond strength of either sealer (p<0.05). Two percent chlorhexidine did not adversely affect the bond strength of the sealers, whereas 2.5% sodium hypochlorite solution damaged AH Plus/gutta-percha bond strength.     

Enterococcus faecalis type strain leakage through root canals filled with Gutta-Percha/AH plus or Resilon/Epiphany

The aim of this in vitro study was to compare leakage of Enterococcus faecalis ATCC 29212 through root canals of single-rooted extracted human mandibular premolars filled with either gutta-percha/AH Plus or Resilon/Epiphany using the continuous wave of condensation technique. Test and control teeth were suspended in an experimental bacterial leakage setup for 50 days. Kaplan-Meyer curves showed a tendency of the gutta-percha/AH Plus root fillings to prevent leakage better than Resilon/Epiphany counterparts. This tendency, however, was not statistically significant (log-rank test, p = 0.141). The estimated mean time for turbidity to occur in the broth below the suspended root was 35 days (SD = 5 days) in the gutta-percha/AH Plus and 33 days (SD = 4 days) in the Resilon/Epiphany group. It was concluded that within the limitations of this study, there was no apparent advantage of using Resilon/Epiphany over gutta-percha/AH Plus.     

Long-term Outcomes of Endodontic Treatment Performed with Resilon/Epiphany

Introduction

Resilon (Resilon Research LLC, Madison, CT) with Epiphany Sealer (Pentron Clinical Technologies, Wallingford, CT) was introduced into the market in 2004 as a new method of root canal obturation. This material as well as the traditionally used gutta-percha with AH Plus sealer (Dentsply Maillefer, Tulsa, OK) were in use over a 9-year span in the University of North Carolina endodontic clinics. Although Resilon was initially thought to create a “monoblock” seal between the material and the canal, in vitro studies later suggested this concept not to be true. The long-term outcome of Resilon using a validated radiographic index and a systematic approach has not been reported. The purpose of this retrospective cohort study was to radiographically evaluate the outcome of Resilon/Epiphany-treated root canals compared with traditional gutta-percha/AH Plus.

Push-out bond strengths: the Epiphany-Resilon endodontic obturation system compared with different pairings of Epiphany, Resilon, AH Plus and gutta-percha

AIM: To assess the bond strength of the new resin-based Epiphany-Resilon root canal filling system, and to compare this with bond strengths of different pairings of AH Plus, gutta-percha, Epiphany and Resilon. METHODOLOGY: A total of 65 extracted human single-rooted teeth were used. All teeth were instrumented using a set of ProTaper rotary instruments. Irrigation was performed with 15 mL of 1.25% NaOCl between each instrument and the smear layer was removed during and after instrumentation with 5 mL of 17% EDTA. The canal spaces were filled with different combinations of core and sealer using lateral condensation, as follows: group 1, AH Plus + gutta-percha; group 2, AH Plus + Resilon; group 3, Epiphany + Resilon; group 4, Epiphany + gutta-percha; group 5 (control), gutta-percha only. Cylinders of root dentine 1.13 (0.06)-mm long were prepared from the coronal sections of the 65 teeth. The test specimens were subjected to the push-out test method. After adhesion testing, the remaining sections were examined under a stereomicroscope at x 25 magnification to determine the nature of bond failure. The values of bond strength were analyzed by one-way analysis of variance (ANOVA) and the post hoc Tukey's test, with significance set at P < 0.05. RESULTS: The respective mean push-out test values for groups 1-5 were: 2.000 +/- 0.369, 1.380 +/- 0.154, 1.706 +/- 0.340, 2.857 +/- 0.523 and 0.078 +/- 0.027 MPa. Significant difference (P < 0.001) occurred between the groups. Multiple paired comparisons (Tukey's test) revealed that group 4 (Epiphany + gutta-percha) had significantly (P < 0.001) greater bonding strength than all the other groups; group 1 (AH Plus + gutta-percha) had significantly (P < 0.05) greater bonding strength than group 2 (AH Plus + Resilon); and group 5 (control) had significantly (P < 0.05) lower bonding strength than all the other groups. Inspection of the surfaces revealed the bond failure to be mainly adhesive to dentine for all groups. CONCLUSIONS: The Epiphany-Resilon combination (group 3) was not superior to that of the AH Plus-gutta percha combination (group 1).     

A fluid filtration comparison of gutta-percha versus Resilon, a new soft resin endodontic obturation system

The purpose of this study was to compare the sealing ability of gutta-percha and AH Plus sealer versus Resilon and Epiphany Resin Root Canal sealer using three different final irrigants with the fluid filtration model. There were 140 teeth prepared using a crown-down method to a size 50 file. The teeth were randomly divided into two groups: (A) GP and AH Plus and (B) Resilon and Epiphany. After removal of the smear layer each group was irrigated with either 5.25% NaOCl, 0.012% chlorhexidine (CHX), or 2% CHX for 10 minutes. Obturation was performed using the continuous wave of condensation. The teeth were stored for 20 days in 100% humidity before testing. Two-way ANOVA analysis indicated significantly less leakage (p < 0.05) using Resilon with Epiphany sealer compared to gutta-percha and AH Plus sealer. There was no statistical significance between any of the irrigants used for either obturation group.     

Apical sealing ability of Resilon/Epiphany versus gutta-percha/AH Plus: immediate and 16-months leakage

AIM: To compare the long-term apical sealing ability of gutta-percha/AH Plus and Resilon/Epiphany. METHODOLOGY: The root canals of 90 single-rooted human mandibular premolars with single narrow root canals were prepared with ProFile 0.4 taper instruments to apical size 40. After each instrument, the canals were irrigated with 1% sodium hypochlorite. Subsequently, the teeth were randomly divided into four groups containing 20 teeth each. Additionally, 10 prepared premolars served as positive and 10 counterparts with intact crowns as negative controls. The root canals were filled with gutta-percha/AH Plus or Resilon/Epiphany using lateral or vertical compaction. Specimens were allowed to set for 7 days at 37 degrees C and 100% humidity. Subsequently, the root fillings were removed down to the apical 4 mm. Fluid movement was then assessed using a fluid transportation model and re-evaluated after 16 months of water storage. Leakage within and between groups was compared using nonparametric tests. RESULTS: Negative controls revealed no fluid movement and positive controls displayed gross fluid movement at both times of observation. At the immediate measurement, there were no significant differences between the experimental groups (Kruskal-Wallis, P > 0.05). Gutta-percha/AH Plus fillings retained their seal after 16-months storage (Wilcoxon, P > 0.05), whilst the Resilon/Epiphany groups lost their sealing capacity (Wilcoxon, P < 0.001). In these groups, 29 of the 40 specimens exhibited gross leakage similar to positive controls. CONCLUSION: Initially, Resilon/Epiphany root fillings prevented fluid movement to the same degree as gutta-percha/AH Plus counterparts, but showed more fluid movement when tested at 16 months.     

Comparative assessment of ActiV GP/glass ionomer sealer, Resilon/Epiphany, and gutta-percha/AH plus obturation: a bacterial leakage study

The objective of this study was to compare the sealing ability of ActiV GP/glass ionomer (GI) sealer (Brasseler USA, Savannah, GA), Resilon/Epiphany (Pentron Clinical Technologies, Wallingford, CT), and gutta-percha (GP)/AH Plus (Dentsply Maillefer, Tulsa, OK). Seventy-three human single-rooted teeth were randomly divided into three test groups (20 canals each) and two control groups (5 positive and 8 negative). Using Enterococcus faecalis, a split-chamber bacterial leakage model was developed to evaluate the sealing ability of the three obturation systems. Samples were monitored every 24 hours for 65 days. Thirteen teeth leaked in both the Resilon/Epiphany and GP/AH Plus groups, whereas 17 teeth leaked in the ActiV GP/GI group at the end of the observation period. There were no statistically significant differences in the resistance to leakage between the three obturation systems (p > 0.05).     

Coronal and apical leakage analysis of two different root canal obturation systems

This study compared the coronal and apical leakage of AH Plus with gutta-percha to that of Epiphany with Resilon. Twenty-four single rooted teeth were instrumented and divided into 2 groups according to the solutions for smear layer removal and the obturation materials employed: Group A - 17% EDTA-T and AH Plus with gutta-percha; Group B - primer and Epiphany with Resilon. The Group B specimens were light-cured in the coronal area for 20 s. The external root surfaces were covered with a double layer of ethyl cyanoacrylate, except for the apical foramen and the cavity access. The teeth were immersed in 0.5% methylene blue for 48 h. The specimens were rinsed, dried and axially split for dye penetration measurement with the ImageLab 2.3 software. The t-test showed no significant differences for coronal leakage between the groups, but there were significant differences for apical leakage between the groups (P < 0.05). AH Plus with gutta-percha and Epiphany with Resilon provided the same coronal seal, whereas Epiphany with Resilon provided the best apical seal.     

Interfacial strength of Resilon and gutta-percha to intraradicular dentin

Strengthening of Resilon-filled roots via an adhesive interface should be reflected by improvement in the interfacial strength and dislocation resistance between the root fillings and intraradicular dentin. This study compared the interfacial strengths of Resilon/Epiphany and gutta-percha/AH Plus using a thin-slice push-out test design. Failure modes of root slices after push-out testing were examined with environmental scanning electron microscopy. The gutta-percha group exhibited significantly higher interfacial strength than the Resilon group, when premature failures that occurred in Resilon root slices were included in the statistical analysis. The gutta-percha root slices failed exclusively along the gutta-percha/sealer interface. The Resilon root slices failed predominantly along the sealer/dentin interface with recognizable, fractured resin tags. Detachment of the Resilon from the Epiphany sealer was also surprisingly observed in some specimens. The similarly low interfacial strengths achieved with both types of root filling challenges the concept of strengthening root-filled teeth with the new endodontic material.     

Influence of filling materials on the bonding interface of thin-walled roots reinforced with resin and quartz fiber posts

Introduction

A common complication during the restoration of severely destroyed teeth is the loss of coronal root dentine. The aim of this study was to evaluate the influence of different sealers on the bonding interface of weakened roots reinforced with resin and fiber posts.

Methods

Sixty extracted maxillary canines were used. The crowns were removed, and the thickness of root dentine was reduced in the experimental (n = 40) and positive control (n = 10) groups. The specimens of experimental group were assigned to four subgroups (n = 10) according to the filling material: gutta-percha + Grossmann’s sealer, gutta-percha + AH Plus (Dentsply De Trey Gmbh, Konstanz, Germany), gutta-percha + Epiphany (Pentron Clinical Technologies, Wallingford, CT), and Resilon (Resilon Research LLC, Madison, CT) + Epiphany. In the negative control group (n = 10), canals were not filled. After post space preparation, the roots were restored with composite resin light-activated through a translucent fiber post. After 24 hours, specimens were transversally sectioned into 1-mm-thick slices. Push-out test and scanning electron microscopic (SEM) analyses of different regions were performed. Data from push-out test were analyzed by using Tukey post hoc multiple comparison tests. The percentage of failure type was calculated. Data from SEM analysis were compared by Friedman and Kruskal-Wallis tests (α = 0.05).

Results

The mean bond strength was significantly higher in the negative control group as compared with the other groups (P < .05). In all groups, the most frequent type of failure was adhesive. Overall, apical and middle regions presented a lower density of resin tags than the coronal region (P < .05).

Conclusions

The push-out bond strength was not affected by sealer or region. The canal region affected significantly the resin tag morphology and density at the bonding interface.     

Ultrastructural evaluation of the apical seal in roots filled with a polycaprolactone-based root canal filling material

This in vitro study compared the ultrastructural quality of the apical seal achieved with Resilon/Epiphany and gutta-percha/AH Plus. Single-rooted extracted human teeth were prepared using a crown-down technique, debrided with NaOCl and EDTA, and obturated with either Resilon/Epiphany or gutta-percha/AH Plus. They were examined for gaps along canal walls using SEM, and for apical leakage using a transmission electron microscopy (TEM). SEM revealed both gap-free regions, and gap-containing regions in canals filled with both materials. TEM revealed the presence of silver deposits along the sealer-hybrid layer interface in Resilon/Epiphany, and between the sealer and gutta-percha in the controls. It is concluded that a complete hermetic apical seal cannot be achieved with either root filling materials.     

EVALUATION OF APICAL MICROLEAKAGE OF TEETH SEALED WITH FOUR DIFFERENT ROOT CANAL SEALERS

Objectives:

to compare the apical sealing ability of four root canal sealers. Materials and methods: forty extracted human maxillary canines were instrumented 1 mm short of the anatomical apex and randomly assigned to four groups (n=10), according to the root canal sealer used for obturation: Endofill, AH Plus, EndoREZ and Epiphany. Root canals were obturated with guttapercha points, except for the Epiphany group, in which resin points (Resilon) were used. The teeth were immersed in India ink for seven days and clarified using methyl salicylate. The extent of apical dye penetration was measured with a measuroscope in all aspects of the canal.

Results:

AH Plus (0.02 mm ± 0.07), Epiphany (0.00 mm ± 0.00) and EndoREZ (0.32 mm ± 0.62) did not differ statistically to each other (p>0.01). EndoFill presented the highest dye penetration mean (0.83 mm ± 0.73) and was statistically different from the other sealers (p<0.01).

Conclusions:

the resin-based root canal sealers presented lesser apical microleakage than the zinc oxide and eugenol based sealer. No statistical differences were observed among resin based sealers.