Retention of fiber posts cemented at different time intervals in canals obturated using an epoxy resin sealer

OBJECTIVES: To evaluate the effect of immediate versus delayed post space preparation and cementation on the retention of different types of fiber posts in canals obturated with an epoxy resin sealer. METHODS: Sixty-eight single-rooted human teeth were decoronated and the root canals were shaped with rotary instruments and obturated with gutta-percha and an epoxy resin sealer. The teeth were divided into four experimental groups according to the different times of post space preparation and cementation: immediate (group 1), 24h (group 2) and 1 week (group 3) after root canal filling. Control group (group 4) with no root canal obturation was included. Two teeth were randomly selected from each group for SEM examination. Each group was further divided into three subgroups of five teeth each (n=5), according to the type of post and the materials used for luting the posts. A push-out test was performed and differences among experimental groups were analyzed with two-way ANOVA and Tukey test (alpha=0.05). RESULTS: Interfacial strength values achieved in group 1, where an immediate cementation was performed, were significantly lower (p<0.05) than those in group 2 and group 3 in which post cementation was performed 24h or 1 week after the root canal filling. Post type affected post retention, FRC Postec and DT Light Post posts achieved higher interfacial strengths than ENA Post (p<0.05). SEM examination revealed a more conspicuous presence of sealer remnants on the walls of immediately prepared post spaces. CONCLUSIONS: Delayed cementation of fiber post resulted in higher retentive strengths irrespective of the post type.     

Novel endodontic sealer with dual strategies of dimethylaminohexadecyl methacrylate and nanoparticles of silver to inhibit root canal biofilms

ObjectiveEndodontic treatment failures and recontamination remain a major challenge. The objectives of this study were to: (1) develop a new root canal sealer with potent and long-lasting antibiofilm effects using dimethylaminohexadecyl methacrylate (DMAHDM) and nanoparticles of silver (NAg); (2) determine the effects of incorporating DMAHDM and NAg each alone versus in combination on biofilm-inhibition efficacy; and (3) determine the effects on sealer paste flow, film thickness and sealing ability, compared to a commercial control sealer.MethodsDual-cure endodontic sealers were formulated using DMAHDM mass fractions of 0%, 2.5% and 5%, and NAg mass fractions of 0.05%, 0.1% and 0.15%. The sealing ability of the sealers was measured using linear dye penetration method. Colony-forming units (CFU), live/dead assay, and polysaccharide production of biofilms grown on sealers were determined.ResultsThe sealer with 5% DMAHDM and 0.15% NAg yielded a flow of (22.18 ± 0.58) which was within the range of ISO recommendations and not statistically different from AH Plus control (23.3 ± 0.84) (p > 0.05). Incorporating DMAHDM and NAg did not negatively affect the film thickness and sealing properties (p > 0.05). The sealer with 5% DMAHDM and 0.15% NAg greatly reduced polysaccharide production by the biofilms, and decreased the biofilm CFU by nearly 6 orders of magnitude, compared to AH Plus and experimental controls (p < 0.05).SignificanceA therapeutic root canal sealer was developed using 5% DMAHDM with biofilm-inhibition through contact-mediated mechanisms, plus 0.15% of NAg to release silver ions into the complex and difficult-to-reach root canal environment. The novel root canal sealer exerted potent antibiofilm effects and reduced biofilm CFU by 6 orders of magnitude without compromising sealer flow, film thickness and sealing ability. This method provided a promising approach to inhibit endodontic biofilms and prevent recurrent endodontic infections.     

Prevention of enamel demineralization after tooth bleaching by bioactive glass incorporated into toothpaste

Background: The aim of this study was to determine the effects of bleaching on the structure of the enamel layer of teeth and the potential of the commercial bioactive glass NovaMin® in two different toothpastes to remineralize such regions of the enamel. Three aspects were considered: the extent and nature of the alterations in the enamel after application of the bleaching agents; the extent of remineralization after application of two commercial toothpastes containing bioactive glass; and whether or not there were differences between the toothpastes in terms of their effectiveness in promoting remineralization. Methods: Bleaching agent based on 16% carbamide peroxide was applied to the enamel surface of freshly extracted human molars for 8 minutes, once a day for 7 days. After the bleaching cycles, the enamel surface was analysed by SEM and EDX. Results: The results obtained in the study lead to the conclusion that application of 16% carbamide peroxide causes distinct morphological changes to the enamel surface which vary from mild to severe. Subsequent treatment with either of the toothpastes containing the bioactive glass NovaMin® resulted in the formation of a protective layer on the enamel surface, consisting of bioactive glass deposits, with only slight differences between the two brands. Application of these dentifrices also caused increases in the Ca and P content of the enamel layer, returning it to that of undamaged enamel. Conclusions: Remineralizing toothpastes should be used after bleaching, in order to repair any damage to the mineral tissue caused by these procedures.     

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.     

The efficiency of different irrigation activation techniques in the removal of calcium silicate-based endodontic sealer from artificially created groove

This study evaluated the removal of a calcium silicate-based sealer (EndoSeal MTA) with needle irrigation (NI), passive ultrasonic irrigation (PUI), XP-endo Finisher (XPF) and EDDY. A total of 56 human mandibular premolars were instrumented up to size 40.04 taper. The roots were separated longitudinally, and grooves were prepared with an ultrasonic tip at one-half of each root canal. The grooves were covered with EndoSeal MTA and re-attached roots were investigated based on the activation techniques applied. The results showed that significantly more material (p < 0.05) was removed in the EDDY group compared to the NI, PUI and XPF groups in the apical region. In the coronal region, no significant difference was observed between EDDY, XPF and PUI (p > 0.05), whereas all the latter were significantly more effective than NI (p < 0.05). These findings show that the removal of EndoSeal MTA can be more effective with EDDY compared to XPF, PUI and NI in the apical region.     

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.     

A comparison of lithium-substituted phosphate and borate bioactive glasses for mineralised tissue repair

ObjectivesWnt/β-catenin signalling plays important roles in regeneration, particularly in hard tissues such as bone and teeth, and can be regulated by small molecule antagonists of glycogen synthase kinase 3 (GSK3); however, small molecules can be difficult to deliver clinically. Lithium (Li) is also a GSK3 antagonist and can be incorporated into bioactive glasses (BG), which can be used clinically in dental and bone repair applications and tuned to quickly release their constituent ions.MethodsHere, we created phosphate (P)- and borate (B)-based BG that also contained Li (LiPBG and LiBBG) and examined their ion release kinetics and the toxicity of their dissolution ions on mouse 17IA4 dental pulp cells.ResultsWe found that although LiPBG and LiBBG can both quickly release Li at concentrations known to regulate Wnt/β-catenin signalling, the P and B ions they concomitantly release are highly toxic to cells. Only when relatively low concentrations of LiPBG and LiBBG were placed in cell culture medium were their dissolution products non-toxic. However, at these concentrations, LiPBG and LiBBG’s ability to regulate Wnt/β-catenin signalling was limited.SignificanceThese data suggest that identifying a BG composition that can both quickly deliver high concentrations of Li and is non-toxic remains a challenge.     

High phosphate content in bioactive glasses promotes osteogenesis in vitro and in vivo

ObjectivesHigh phosphate content was found to significantly increase apatite formation of bioactive glasses (BGs) in vitro. However, there is very limited understanding of the effect of phosphate contents on osteogenesis which is important for clinical applications. The aims of this study were to investigate how phosphate content influences apatite formation ability of bioactive glasses in α-MEM culture medium and whether high phosphate content in bioactive glasses promotes osteogenesis in vitro and in vivo.MethodsFour phosphate containing bioactive glasses were synthesized via a melt-quench method and characterized using X-ray powder Diffraction (XRD), TGA-DSC and Fourier transform infra-red spectroscopy (FTIR). The apatite formation ability in α-MEM culture medium and the in vitro and in vivo osteogenic potential of these bioactive glass were explored.ResultsFTIR spectra confirmed faster apatite formation with an increase in phosphate content. The culture media containing ions released from the BGs showed enhanced cell viability and alkaline phosphatase activity of osteoblasts. Osteoblasts cultured with extracted BGs culture media generally showed increased proliferation, mineralized nodule formation, osteogenic and angiogenic genes expression with an increase in phosphate content in the glass compositions. An in vivo study demonstrated a larger amount of new bone formation in the calvarial defects implanted with high phosphate containing BG granules compared with that of BG without the presence of phosphate at 8 weeks post-surgery.SignificantThe presence of higher phosphate content accelerates apatite formation and promotes osteogenesis, indicating that both apatite formation and osteogenesis of bioactive glasses can be tailored by varying phosphate content for specific clinical needs and personalized treatments.     

pH, calcium ion release, and setting time of an experimental mineral trioxide aggregate-based root canal sealer

Introduction

An experimental mineral trioxide aggregate sealer (MTAS) has been developed for use as a root canal sealer. The aim of this study was to evaluate the setting time, pH, and calcium ion release of MTAS compared with white Portland cement (CPB-40; Votorantin Cimentos, Camargo Correa SA, Pedro Leopoldo, MG, Brazil), white MTA Angelus (MTA; Angelus, Londrina, PR, Brazil), and AH Plus (Dentsply DeTrey, Konstanz, Germany).

Methods

For the evaluation of setting time, each material was analyzed using Gilmore-type needles. Polyethylene tubes with the materials were immersed in distilled water for the measurement of pH (digital pH meter) and calcium release (atomic absorption spectrophotometry). The evaluations were performed at 3, 6, 12, 24, and 48 hours and 7, 14, and 28 days. Data were analyzed by analysis of variance and the Tukey test at 5% significance level.

Results

MTAS showed higher calcium release at all experimental periods, a greater increase in pH up to 48 hours and the longest setting time.

Conclusions

MTAS presented favorable properties for its indication as a root canal sealer.     

A review of the effect of various ions on the properties and the clinical applications of novel bioactive glasses in medicine and dentistry

Bioactive glass is a novel material that dissolves and forms a bond with bone when exposed to body fluids. Bioactive glasses are silicate-based, with calcium and phosphate in identical proportions to those of natural bone; therefore, they have high biocompatibility. Bioactive glasses have wide-ranging clinical applications, including the use as bone grafts, scaffolds, and coating materials for dental implants. This review will discuss the effects of ions on the various compositions of bioactive glasses, as well as the clinical applications of bioactive glasses in medicine and dentistry.     

An in vitro evaluation of the growth of human periodontal ligament fibroblasts after exposure to a 4-META-containing methacrylate-based endodontic sealer

Introduction

In this study we evaluated the cytotoxic effects of MetaSEAL, a 4-META-containing meth-acrylate-based endodontic sealer, on human periodontal ligament (HPDL) fibroblasts. There are a limited number of studies on the cytotoxic effects of MetaSEAL, and there are no studies on the cytotoxic effects of MetaSEAL on cells it might come into contact with in vivo.

Methods

MetaSEAL concentrations of 25, 50, 100, 200, 400, and 800 μg/mL were exposed to HPDL fibroblast cultures and evaluated at 1, 3, 7, 14, and 21 days. Controls included untreated cells and cells treated with ethanol, the vehicle for MetaSEAL suspension. Crystal violet staining in 24-well plates and the fluorescence-based CyQUANT Cell Proliferation Assay in 96-well plates assessed fibroblast viability.

Results

Significant cytotoxicity against HPDL growth by MetaSEAL was both time- and concentration-dependent. At day 1 there were no significant cytotoxic effects, whereas by day 3, 800 μg/mL concentration, by day 7, 200, 400, and 800 μg/mL concentrations, and by day 14, 50, 100, 200, 400, and 800 μg/mL concentrations were significantly cytotoxic. By day 21, all concentrations were significantly cytotoxic. These findings were confirmed by both the crystal violet and CyQUANT assays.

Conclusions

MetaSEAL endodontic sealer has increasing HPDL cytotoxicity with both concentration and time exposure.     

生物活性玻璃治疗牙周骨下袋的临床研究

目的：评价生物活性玻璃（bioactive glass,BAG)治疗牙周骨下袋的临床疗效。方法：随机选择性经过牙周基础治疗的20处牙周骨缺损，其中13处进行翻瓣术加BAG移植，另外7处只做翻瓣术加以对照。通过术后3、6个月的复查，比较两组的临床疗效。结果：BAG组术前的探诊深度、附着丧失和出血指数分别为6．19mm、6．31mm和2．77，术后6个月时分别为3．23mm、3．65mm和0．65；翻瓣组术前的探诊深度、附着丧失和出血指数分别为6．86mm、7．71mm和2．93，术后6个月时分别为4.50mm、5．35mm和1．93。术后BAG组和翻瓣组的探诊深度、附着丧失及BAG组的拙血指数均比术前明显减少。BAG组的上述指标均低于翻瓣组，BAG组的出血指数减少值显著大于翻瓣组。结论：翻瓣术BAG植入和单纯翻瓣术均能明显改善下袋患牙的临床指标，而前者的临床疗效优于后者,在减轻牙周炎症方面更为突出。     

Effect of chlorhexidine digluconate on antimicrobial activity,cell viability and physicochemical properties of three endodontic sealers

ObjectiveAssess the biological and physicochemical properties of AH Plus, BioRoot RCS and Pulp Canal Sealer (PCS) leachates with and without chlorhexidine (CHX).MethodsThe sealers were studied in no contact and 1-minute contact with CHX. For biological properties (antibacterial activity and cytotoxicity), leachates were formed in saline of freshly mixed, 1-, 7- and 28 days set sealers. The antibacterial properties of sealer leachates were investigated for planktonic and biofilm growth of E. faecalis, S. mutans, S.epidermidis and S.aureus. The 3-(4,5 dimethylthiazolyl-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay was used to evaluate murine fibroblast cell viability after exposure to the leachates. The physical properties (water uptake, sorption, solubility, porosity, surface characteristics) of sealers and the pH of the immersion liquid (saline or distilled water) were also assessed over a 28-days period.ResultsCHX improved the antibacterial properties of the sealer leachates and reduced cell viability for all sealer leachates, except for freshly mixed PCS. BioRoot RCS leachates presented the highest antibacterial properties and cell viability with and without CHX contact. PCS was the material most affected by CHX in terms of physical properties, whereas for AH Plus, solubility was increased. CHX did not affect the physical properties of BioRoot RCS, except for solubility that was decreased. CHX contact did not change sealers’ alkalinity in distilled water whereas it increased it for AH Plus and BioRoot RCS in saline.SignificanceCHX improved the antibacterial efficacy of sealer leachates and either compromised or did not affect cell viability. CHX affected to various extent sealers’ physicochemical properties.     

The effect of smear layer upon the coronal leakage of gutta-percha root fillings and a glass ionomer sealer

The effect of the removal of the smear layer on coronal leakage of root fillings was studied using two sealer cements. Sixty single-rooted teeth with mature apices were prepared chemomechanically using a modified double-flared technique with non-cutting tipped files and copious irrigation with 2% sodium hypochlorite. The teeth were randomly allocated to four groups of 15 teeth each. Two groups were treated with 40% citric acid to remove the smear layer. Two groups of teeth, one with and one without smear layer, were filled by lateral condensation of gutta-percha with either Tubliseal or a resin-based glass ionomer, Vitrebond. The teeth were stored for 1 week, thermocycled, and the extent of coronal leakage determined for each group after immersion in Indian ink for 90 h. The teeth were demineralized, dehydrated and immersed in methyl salicylate which rendered them transparent. Linear measurement of dye penetration was recorded. The mean depth (+/- SD) of leakage for the groups in which the smear layer was left intact was 4.26 +/- 1.53 mm and 6.83 +/- 1.65 mm for the Vitrebond and Tubliseal, respectively. When the smear layer had been removed, the mean depth of leakage for the Vitrebond group was 1.13 +/- 0.29 mm, and 3.72 +/- 1.23 mm for the Tubliseal group. There was a statistically significant difference in leakage between the groups (P < 0.001). With both sealers, those teeth in which the smear layer had been removed showed less leakage than the specimens in which the smear layer was left intact (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)     

The influence of experimental bioactive glasses on pulp cells behavior in vitro

ObjectivesTo assess in vitro the effect of experimental mesoporous BAG, on human dental pulp cells (hDPCs) behavior in terms of cytocompatiblity and bioactivity via mineralization potential.MethodsFine (FP) and large particles (LP) of a fixed BAG composition named 0NaMBG have been elaborated by a sol-gel process. In vitro assessment was achieved on cultured primary hDPCs using indirect contact. The effect of the concentration of 800 μg/mL on cell metabolic activity and cytotoxicity were examined by performing Alamar blue and crystal violet assays. Alizarin Red staining was used to detect and quantify the formation of mineralized nodules and ALP activity was colourimetrically quantified. The expression of Odontogenic markers: DMP-1 and osteopontin (OPN) expression and cell morphology was evaluated by confocal microscopy.ResultsAccording to the Alamar blue and crystal violet assay, 0NaMBG samples were non-cytotoxic. Cells treated with 0NaMBG particles expressed higher metabolic activity than control cells, especially for LP. Both FP and LP significantly increased both extra and intra cellular ALP activity. hDPCs exhibited good cell spreading and adhesion in the presence of FP and LP extracts by confocal imaging. Further, Alizarin red S assay demonstrated more mineralization nodules and significant enhancement of the extracellular calcium deposition when cells were interfaced with both FP and LP compared to the control cells. Moreover, LP extracts enhanced the production and secretion of odontogenic markers: dentin matrix protein 1 (DMP-1) and osteopontin.SignificanceLP have a higher surface area and pore volume, which could explain their greater bioactivity in contact with pulp cells. The clinical relevance of these findings implicate that 0NaMBG could be used as fillers in dental therapeutic materials suitable for dentin and/or pulp tissues preservation.     

Tissue response to an experimental calcium hydroxide-based endodontic sealer: a quantitative study in subcutaneous connective tissue of the rat

Abstract Silicone tubes containing a freshly mixed experimental Sealapex, in which titanium dioxide was removed from the original formula, were implanted in the dorsal subcutaneous connective tissue of the rat. Solid silicone rods of the same size as the tubes were also implanted and used as inert controls. The tissue reaction to both these materials was histometrically and quantitatively studied under light microscopy and by elemental electron microprobe analysis. After 7, 30 and 90 d of implantation, different grades of tissue reaction to the tested materials were recorded. A granulomatous tissue containing numerous foreign-body giant cells and macrophages with engulfed particles in their cytoplasms was initially detected in contact with the test material. In addition, many fibroblasts and newly formed vessels were also observed at these areas. The results of this study revealed that these reactions increased progressively at the 30-and 90-d observations. The electron microprobe analysis of the granulomatous tissues showed the presence of heavy components of the experimental material.     

载银锌介孔钙硅纳米粒子根管密封性能的研究

目的 评价载银锌介孔钙硅纳米粒子(silver and zinc incorporated mesoporous calcium-silicate nanoparticles,Ag-Zn-MCSNs)作为根管封闭剂的理化性能及根管密封性能.方法 测定MCSNs、Ag-MCSNs、Zn-MCSNs、Ag-Zn-MCSNs...