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Chan AYY, Chang JWW, Cheung GSP, Neelakantan P, Zhang C, Lee AHC. Penetration of Calcium Silicate and Epoxy Resin Sealers Into the Lateral Canals. Int Dent J 2024; 74:762-768. [PMID: 38350801 PMCID: PMC11287132 DOI: 10.1016/j.identj.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES The aim of this research was to compare the penetration ability of calcium silicate-based sealers (iRoot SP and TotalFill BC HiFlow) and an epoxy resin-based sealer (AH Plus) into the lateral canals using the single-cone (SC) or continuous wave compaction (CW) obturation techniques. METHODS Ninety single-rooted human teeth received canal instrumentation and diaphanisation before artificial lateral canals were created at 3 different root levels. The specimens were randomly allocated into 6 groups based on the combination of obturation technique and sealer used. Radiographic and photographic measurements evaluated the percentage of sealer penetration. Statistical analysis was performed to compare the penetration ability amongst different types of sealers, obturation methods, and root levels. RESULTS Although TotalFill BC HiFlow sealer combined with the CW technique demonstrated greater sealer penetration at the coronal level (P < .05), the overall penetration ability of iRoot SP, TotalFill BC HiFlow, and AH Plus was not significantly different. The deepest sealer penetration was observed at the apical root level. CONCLUSIONS All sealers showed similar penetration abilities into the lateral canals using the SC or CW techniques in vitro. Calcium silicate-based sealers have comparable penetration ability into lateral canals compared to epoxy resin-based sealers using SC or CW obturation techniques.
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Affiliation(s)
- Angel Yuk Yan Chan
- Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, P. R. China
| | - Jeffrey Wen Wei Chang
- Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, P. R. China
| | - Gary Shun Pan Cheung
- Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, P. R. China
| | - Prasanna Neelakantan
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, USA
| | - Chengfei Zhang
- Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, P. R. China.
| | - Angeline Hui Cheng Lee
- Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, P. R. China.
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Fischer BV, Dias-Junior LCDL, Minamisako MC, Almeida CM, da Silva LR, Bortoluzzi EA, Teixeira CDS, Garcia LDFR. Effect of the timing of primary endodontic treatment and dosage of radiation therapy on the filling material removal. AUST ENDOD J 2024; 50:321-333. [PMID: 38596885 DOI: 10.1111/aej.12846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/11/2024] [Accepted: 04/01/2024] [Indexed: 04/11/2024]
Abstract
This study investigated the effect of the timing of primary endodontic treatment and dosage of radiotherapy on the remaining filling material (RFM) during endodontic reintervention. 60 single-rooted human mandibular premolars were distributed into five groups (n = 12), according to the timing and dosage of radiation (55Gy or 70Gy): NegativeCG-non-irradiated teeth; Endo-pre-RT55/70-obturation before irradiation (55Gy or 70Gy); Endo-post-RT55/70-obturation and reintervention after irradiation (55Gy or 70Gy). Roots were cleaved and analysed under stereomicroscope and Scanning Electron Microscope to quantify (%) the RFM. Experimental groups had a significantly greater amount (p < 0.05) of RFM in the middle and apical thirds than the control group, except for Endo-pre-RT55 in the middle third (p < 0.0001). The apical third had greater amount of RFM (p < 0.05). Radiation therapy, before and after primary endodontic treatment, increased the amount of RFM, regardless of the dose delivered. When necessary, reintervention preferably must be performed before radiation therapy.
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Affiliation(s)
- Bruna Venzke Fischer
- Department of Dentistry, Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Luiz Carlos de Lima Dias-Junior
- Department of Dentistry, Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | | | - Cristiane Maria Almeida
- Department of Radiotherapy, Oncology Research Center (CEPON), Florianópolis, Santa Catarina, Brazil
| | - Luciano Roberto da Silva
- Department of Radiotherapy, Oncology Research Center (CEPON), Florianópolis, Santa Catarina, Brazil
| | - Eduardo Antunes Bortoluzzi
- Department of Diagnosis & Oral Health, Division of Endodontics, School of Dentistry, University of Louisville, Louisville, Kentucky, USA
| | - Cleonice da Silveira Teixeira
- Department of Dentistry, Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Lucas da Fonseca Roberti Garcia
- Department of Dentistry, Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
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Hadid GG, Ventura MA, Ramirez I, Assis HCD, Camargo RVD, Sousa-Neto MDD, Mazzi-Chaves JF, Lopes-Olhê FC. Influence of Initial Root Canal Treatment on Intratubular Penetrability and Bond Strength of Nonsurgical Retreatment: An InVitro Study. J Endod 2024:S0099-2399(24)00406-0. [PMID: 39094780 DOI: 10.1016/j.joen.2024.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/16/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION To assess the effect of combinations of two different endodontic sealers used in initial and endodontic retreatment on the bond strength of the secondary obturation and the penetrability of the sealers. METHODS Forty-eight mandibular premolars were used, receiving standardized endodontic access and biomechanical preparation. Twenty-four teeth received AH Plus sealer (AHP) in primary obturation and the others received Bio-C Sealer (BCS). Retreatment protocol was performed with an R50 instrument. The samples were further subdivided into four groups (n = 12) based on the combination of primary/secondary obturation sealers: AHP/AHP; AHP/BCS; BCS/AHP; and BCS/BCS. Four samples from each subgroup received the addition of fluorophores to the sealer for penetrability analysis using laser scanning confocal fluorescence microscopy. The root portion on the 8 push-out samples was sectioned into 6 slices of 1.0 mm. Bond strength (BS) was assessed using a universal testing machine until displacement of the filling mass. Failure pattern was evaluated under a stereomicroscope (20× magnification). BS data were analyzed using two-way analysis of variance followed by Tukey's test (P < .05), and the association between the failure pattern and BS value was assessed using the chi-square test (P < .05). Penetrability was qualitatively evaluated. RESULTS The highest BS values were observed in the AHP/AHP (4.54 ± 1.5 MPa) and BCS/AHP (5.00 ± 1.0 MPa) groups (P < .05), with a higher percentage of adhesive failures to the filling material for all groups. Laser scanning confocal fluorescence microscopy images indicated greater penetrability of AHP compared to BCS, both in initial treatment and retreatment. CONCLUSION AHP sealer exhibited higher BS and greater penetrability compared to BCS sealer.
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Affiliation(s)
- Gabriela Gavilán Hadid
- Postgraduate Student, Departament of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), São Paulo, Brazil
| | - Miguel Angel Ventura
- Postgraduate Student, Departament of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), São Paulo, Brazil
| | - Iago Ramirez
- Postgraduate Student, Departament of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), São Paulo, Brazil
| | - Helena Cristina de Assis
- Postgraduate Student, Departament of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), São Paulo, Brazil
| | - Rafael Verardino de Camargo
- Postgraduate Student, Departament of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), São Paulo, Brazil
| | - Manoel Damião de Sousa-Neto
- Professor, Departament of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), São Paulo, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Professor, Departament of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), São Paulo, Brazil.
| | - Fabiane Carneiro Lopes-Olhê
- Professor, Departament of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), São Paulo, Brazil
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Seron MA, Nunes GP, Ferrisse TM, Strazzi-Sahyon HB, Dos Santos PH, Gomes-Filho JE, Cintra LTA, Sivieri-Araujo G. Influence of bioceramic sealers on dentinal tubule penetration and antimicrobial effectiveness: a systematic review and meta-analysis of in vitro studies. Odontology 2024; 112:672-699. [PMID: 38374511 DOI: 10.1007/s10266-024-00904-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/08/2024] [Indexed: 02/21/2024]
Abstract
The aim of this systematic review and meta-analysis (SRM) was to evaluate whether bioceramic sealers have better penetration capacity in dentinal tubules and antimicrobial activity when compared to AH Plus® sealer. This SRM was recorded in the Open Science Framework database and followed the guidelines of the PRISMA 2020. Five databases were searched by two independent reviewers. Only in vitro studies that evaluated the effects of bioceramic sealers on dentinal tubule penetration and antimicrobial activity outcomes compared to AH Plus® sealer were included. Meta-analysis was conducted using R software, using the effect measure of the standardized mean difference (SMD) and inverse variance method. A modified Joanna Briggs Institute's Checklist was used for the risk of bias assessment. A total of 1486 studies were identified, and only 54 studies that fulfilled our eligibility criteria were included in this review. There was no statistical difference between the sealers evaluated for dentinal tubule penetration, in the thirds evaluated: coronal SMD 0.58 [0.14; 1.31], p = 0.12; middle SMD 0.07 [0.54; 0.39], p = 0.75; and apical SMD 0.08 [0.73; 0.56], p = 0.80. Both sealers demonstrated similar antimicrobial action (SMD [3.42; 5.32], p = 0.67 and SMD 0.67 [1.89; 0.55], p = 0.28). The studies presented a low risk of bias. Based on the in vitro studies included and according to the limitations of the present review, the data suggest that bioceramic and AH Plus® sealers present similar penetration capacity in dentinal tubules and antimicrobial effect, making them suitable materials to be considered in clinical practice.
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Affiliation(s)
- Marcelo Augusto Seron
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Gabriel Pereira Nunes
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil.
| | - Tulio Morandin Ferrisse
- Oral Medicine, Department of Diagnosis and Surgery, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Henrico Badaoui Strazzi-Sahyon
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Paulo Henrique Dos Santos
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - João Eduardo Gomes-Filho
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Gustavo Sivieri-Araujo
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
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Juha W, Sarkis E, Alsayed Tolibah Y. Three-dimensional assessment of obturation volume in lateral canals after three obturation techniques with bioceramic sealer: an in vitro comparative study. BDJ Open 2024; 10:50. [PMID: 38886384 PMCID: PMC11183128 DOI: 10.1038/s41405-024-00240-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/21/2024] [Accepted: 05/31/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVE This study aimed to evaluate the obturation ability of simulated lateral canal in mandibular premolars at three levels (3, 5, and 7 mm) from the apex using gutta-percha and BC Sealer HiFlow (BCHiF) with different obturation techniques, including continuous wave compaction (CWC), cold lateral condensation (CLC), and single cone (SC) techniques, by a 3D assessment method of the obturation volume with cone beam computed tomography (CBCT) and MIMICS software analysis. METHODS Thirty intact human mandibular premolars were decoronated, instrumented up to #30 taper 4%, and uniformly irrigated with 5.25% NaOCl and 17% EDTA. Six simulated lateral canals (3 pairs) were prepared at 3, 5, and 7 mm from the apex in each root, using #10 modified C-file. CBCT images were obtained, and lateral canal volumes were calculated using MIMICS software. The samples were divided into three groups: CWC (n = 10), CLC (n = 10), and SC (n = 10). All groups were obturated with BCHiF and gutta-percha. Another CBCT image was taken post-obturation, and 3D lateral canal obturation volume percentages were calculated using MIMICS software. Data were analyzed using SPSS software with One-way ANOVA and Sidak tests (α = 0.05). RESULTS Significant differences were observed in the 3D lateral canal obturation volume percentage at all three levels (P < 0.05). Both CWC and CLC techniques demonstrated higher 3D lateral canal obturation volume percentages (x ¯ = 89.64% andx ¯ = 73.28%; respectively) compared to the SC group)x ¯ = 43.10%). CONCLUSION BCHiF combined with the CWC technique has a higher ability to achieve preferable 3D obturation volume in the simulated lateral canal at 3, 5, and 7 mm. CLINICAL RELEVANCE In cases requiring endodontic treatment with lateral canals, the CWC obturation technique using BCHiF with gutta-percha may offer better outcomes compared to other obturation techniques.
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Affiliation(s)
- Wahid Juha
- Department of Endodontics, Aleppo University, Aleppo, Syria
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Li W, Ju B, Cheng G, Lv Z. The efficacy of 3 root canal sealers combined with warm gutta-percha vertical compression technique in the treatment of dental pulp disease. Medicine (Baltimore) 2024; 103:e38414. [PMID: 38875398 PMCID: PMC11175958 DOI: 10.1097/md.0000000000038414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2024] Open
Abstract
To investigate the efficacy of 3 root canal sealants such as AH Plus, GuttaFlow and iRoot SP combined with warm gutta-percha vertical compression technique in the treatment of dental pulp disease. This was a single-center retrospective study. 180 patients with dental pulp disease were divided into AH Plus group (n = 60), GuttaFlow group (n = 60) and iRoot SP group (n = 60) according to the different treatment methods. Patients in different groups were treated with corresponding root canal sealant combined with warm gutta-percha vertical compression technique. The quality of root canal filling, filling time, filling area ratio, the incidence of pain after operation, serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) and efficacy at 6 months after operation were compared among the 3 groups, respectively. The filling time in the GuttaFlow group and the iRoot SP group was significantly shorter than that in the AH Plus group (P < .001). There were significant differences in pain grade (P = .015) and pain rate (P = .016) among the 3 groups, and the pain rate in the GuttaFlow group and the iRoot SP group was significantly lower than that in the AH Plus group (P = .016). The time-point effect, intergroup effect and time-groups effect of serum TNF-α and IL-6 were significantly different (P < .001), and the levels of the 3 groups after treatment were significantly lower than those before treatment (P < .05), and the levels were significantly lower in the GuttaFlow group and the iRoot SP group (P < .05). There were significant differences in efficacy grading and effective rate among the 3 groups (P = .028), and the effective rate of iRoot SP group was significantly higher than that of AH Plus group (P < .05). The iRoot SP or GuttaFlow as root canal sealant combined with warm gutta-percha vertical compression technique in the treatment of dental pulp disease is better than AH Plus, and the former one can shorten the filling time, relieve the postoperative pain and improve the inflammatory response, but the long-term apical sealing effect of iRoot SP is better than GuttaFlow.
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Affiliation(s)
- Wenbo Li
- Department of Stomatology, People's Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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Buyuksungur A, Oncu A, Koohnavard M, Celikten B, Tezer EO, Huang Y, Orhan K. Micro-Computed Tomography Analysis of Resin and Calcium Silicate Based Sealers Removal in Mandibular Molars Curved Canals. Acta Stomatol Croat 2024; 58:134-144. [PMID: 39036324 PMCID: PMC11256872 DOI: 10.15644/asc58/2/3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/13/2024] [Indexed: 07/23/2024] Open
Abstract
Objective The removal of the root canal sealer is an important factor in nonsurgical retreatment. The aim of this study was to compare the removal of AH Plus, Well Root ST, and AH Plus Bioceramic Sealer using Protaper Universal retreatment files. Methods The curved mesio-buccal canals of extracted mandibular molars were prepared with the Protaper Gold file system (up to F2). Specimens were randomly divided into 3 groups and filled with the single cone technique using AH Plus, Well-Root ST, and AH Plus Bioceramic Sealer, respectively. After two weeks, the root canal filling of all specimens was removed using Protaper Universal retreatment files. All specimens were scanned using micro-CT. The remaining volume of the root canal filling was recorded in total and the coronal, middle, and apical third of each specimen. Results Well-Root ST and AH Plus Bioceramic Sealer groups had a higher percentage of total remaining filling material than the AH Plus group (P<0.05). Conclusion This study has shown that the volume of remaining root canal filling was significantly higher in the samples filled with calcium silicate-based sealers.
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Affiliation(s)
- Arda Buyuksungur
- Ankara University, Faculty of Dentistry, Basic Medical Sciences, Ankara, Turkey
| | - Aysenur Oncu
- Lokman Hekim University, Faculty of Dentistry, Department of Endodontics, Ankara, Turkey
| | - Mehrdad Koohnavard
- Lokman Hekim University, Faculty of Dentistry, Department of Endodontics, Ankara, Turkey
| | - Berkan Celikten
- Ankara University, Faculty of Dentistry, Department of Endodontics, Ankara, Turkey
| | - Emine Odabasi Tezer
- Ankara University, Faculty of Dentistry, Department of Endodontics, Ankara, Turkey
| | - Yan Huang
- Department of Oral Health, KULeuven, Belgium
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, China
| | - Kaan Orhan
- Ankara University, Faculty of Dentistry, Department of DentoMaxillofacial Radiology, Ankara, Turkey
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da Costa RP, Alves Dos Santos GN, Petean IBF, Silva-Sousa AC, Camargo RV, Lopes-Olhê FC, Silva-Sousa YTC, Mazzi-Chaves JF, Sousa-Neto MD. Impact of low-fusion gutta-percha cones used in variations of the continuous wave condensation technique with filling sealers based on bioceramic compounds on the quality of root canal filling. Odontology 2024:10.1007/s10266-024-00924-2. [PMID: 38514512 DOI: 10.1007/s10266-024-00924-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/21/2024] [Indexed: 03/23/2024]
Abstract
To evaluate the impact on the quality of filling with of low-fusion and conventional gutta-percha cones. Thirty-six maxillary canines were prepared and divided into three groups: I-conventional cone with Downpack at 200 °C at 4 mm from the WL; II-low-fusion cone with Downpack at 100 °C up to 4 mm from the WL; III-low-fusion cone with Downpack at 100 °C up to 7 mm from the WL. Temperature variations were measured in thirds on the external surface of the root. The bond strength was evaluated using the push-out test. The adhesive interface was analyzed by scanning electron microscopy. The bond strength and the temperature variation data were analyzed using analysis of variance and the failure type using the chi-square test. The low-fusion cone group with 7 mm Downpack showed higher bond strength (4.2 ± 2.7) compared with conventional cones (2.8 ± 1.6) and low-fusion cones with 4 mm Downpack (2.9 ± 1.6) (p < 0.05), with occurrence of a higher number of adhesive failures to the filling material and mixed failures. Relative to temperature variation, there was less temperature change in the apical third, in the low-fusion cone with Downpack 7 mm (1.0 ± 1.0) (p < 0.05). The use of low-fusion cones allowed the continuous wave condensation technique to be performed at a lower depth of Downpack at 100 °C at 7 mm, with less heating in the apical third, without compromising the quality of filling. Using gutta-percha cones with low fusion, which permits a lower condensation temperature and reduced Downpack depth, maintains the quality of filling, in order to minimize possible damage to the periapical tissues.
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Affiliation(s)
- Rui Pereira da Costa
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n., Ribeirão Preto, SP, 14020-904, Brazil
| | - Guilherme Nilson Alves Dos Santos
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n., Ribeirão Preto, SP, 14020-904, Brazil
| | - Igor Bassi Ferreira Petean
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n., Ribeirão Preto, SP, 14020-904, Brazil
| | - Alice Corrêa Silva-Sousa
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n., Ribeirão Preto, SP, 14020-904, Brazil
| | - Rafael Verardino Camargo
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n., Ribeirão Preto, SP, 14020-904, Brazil
| | - Fabiane Carneiro Lopes-Olhê
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n., Ribeirão Preto, SP, 14020-904, Brazil
| | | | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n., Ribeirão Preto, SP, 14020-904, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n., Ribeirão Preto, SP, 14020-904, Brazil.
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Elzanaty TK, Elashiry MM, Mahran AH. Retreatability of NeoSEALER Flo obturated with warm vertical compaction versus single-cone technique using two different retreatment systems. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:286-292. [PMID: 38634031 PMCID: PMC11019814 DOI: 10.4103/jcde.jcde_314_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 12/31/2023] [Accepted: 01/02/2024] [Indexed: 04/19/2024]
Abstract
Aim The aim of this study was to compare the retreatability of NeoSEALER Flo obturated with warm vertical compaction (WVC) and single-cone (SC) techniques using two different retreatment systems. Materials and Methods Thirty-two root canals were shaped and obturated with NeoSEALER Flo either in an SC obturation technique or a WVC technique. Samples were retreated using ProTaper retreatment or EdgeFile XR retreatment system. The percentage of remaining debris after retreatment was analyzed under a scanning electron microscope using ImageJ software. The time taken to reach full working length (WL) and induce patency was recorded. Statistical Analysis Statistical analysis was performed using an unpaired t-test and a one-way analysis of variance test. Results The percentage of remaining debris after retreatment was significantly higher in the SC technique than in the WVC technique, regardless of the retreatment system used. EdgeFile XR system removed more filling material than the ProTaper retreatment system, regardless of the obturation technique. The apical region showed significantly higher remaining debris than other regions in all groups. The WL and patency were achieved faster in the SC group, while in the WVC group, the EdgeFile XR system was faster. Conclusions The WVC technique showed better retrieval of the filling material; however, a longer time was taken for retreatment. EdgeFile XR system performed better in removing filling materials from inside the canals.
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Affiliation(s)
| | - Mohamed M. Elashiry
- Department of Endodontics, Dental College of Georgia, Augusta University, Augusta, GA, USA
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Abeer Hashem Mahran
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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Shin B, Seo JH, Kim W, Ahn YJ, Kim HY, Shon WJ. The flow behavior and sealing ability of calcium silicate root canal cement containing dimethyl sulfoxide: An in vitro study. J Mech Behav Biomed Mater 2024; 150:106156. [PMID: 38041883 DOI: 10.1016/j.jmbbm.2023.106156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 12/04/2023]
Abstract
INTRODUCTION To develop a calcium silicate (CaSi)-based cement containing dimethyl sulfoxide (DMSO) and cement deliver device for new root canal filling technique, and to assess the flow behavior, leakage, and root canal filling quality of CaSi containing DMSO. METHODS CaSi containing DMSO (CSC-DMSO) and CaSi containing PEG (CSC-PEG) were prepared, and the flow characteristics of both cements were compared in gypsum and resin channels using a high-speed camera. Eight root canals were obturated by CSC-DMSO or CSC-PEG using a cement delivery device, and root canal filling quality was assessed in terms of filling length using periapical radiographs. The filling length was evaluated by 'apico-coronal extension,' measuring length in reference to apical constriction. Microleakage was measured for thirty human molars that were randomly filled with CSC-DMSO, CSC-PEG, or gutta-percha and AH plus. Preliminary obturation of CSC-DMSO with cement delivery device in human teeth was analyzed in terms of filling length and void, using periapical radiographs. Statistical analysis was performed with the Kruskal Wallis test for simulated root canal fillings and one-way ANOVA for leakage test. RESULTS The flow speed of CSC-DMSO reduced in gypsum channels compared to resin channels, but CSC-PEG did not exhibit significant differences in the channels. The median absolute value of apico-coronal extension was significantly lower in CSC-DMSO compared to CSC-PEG (p < 0.05). Microleakage did not statistically differ between the groups (p > 0.05). In the preliminary obturation, the mean apico-coronal extension of CSC-DMSO was -0.297 ± 0.724 mm, while CSC-PEG was not feasible due to excess apical extrusions. CONCLUSIONS CSC-DMSO could be considered as an alternative filling material for root canal obturation.
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Affiliation(s)
- Bokyung Shin
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry, Daehak-ro 101, Jongro-gu, Seoul, South Korea
| | - Ji-Hwan Seo
- Department of Mechanical Engineering, Seoul National University, Gwanak-ro 1, Gwanak-gu, Seoul, South Korea
| | - Wonjung Kim
- Department of Mechanical Engineering, Sogang University, Seoul, South Korea
| | - Yu Jin Ahn
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry, Daehak-ro 101, Jongro-gu, Seoul, South Korea
| | - Ho-Young Kim
- Department of Mechanical Engineering, Seoul National University, Gwanak-ro 1, Gwanak-gu, Seoul, South Korea
| | - Won-Jun Shon
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry, Daehak-ro 101, Jongro-gu, Seoul, South Korea.
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D'Amico G, Muwaquet Rodriguez S. Effectiveness of tricalcium silicate-based cements: Systematic review and meta-analysis. Saudi Dent J 2024; 36:208-213. [PMID: 38419984 PMCID: PMC10897538 DOI: 10.1016/j.sdentj.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 03/02/2024] Open
Abstract
Introduction Tricalcium silicate-based cements exhibit several beneficial properties for dental health and biocompatibility, which can induce biomineralisation. Objectives To assess the sealing ability and intratubular penetration of tricalcium silicate-based sealers using warm and cold obturation techniques. Materials and Methods An electronic search was conducted in PubMed, Scopus, and Web of Science databases for endodontically treated teeth with bioceramics and their sealing capacity in root canal obturation published up to February 2023. Results Of the 90 articles, 16 met the inclusion criteria, and only 10 were used for the meta-analysis, of which four addressed intratubular penetration, four addressed sealing capacity, and two addressed both variables. In the sealing capacity group, the meta-analysis concluded a standardised mean difference (SMD) of -1.31 in favour of the test group (warm) with a certain nonsignificant trend (p = 0.081); regarding intratubular penetration, the meta-analysis concluded an SMD = 2.34 in favour of the test group (warm) with significantly greater penetration (p = 0.032). Conclusion The warm obturation technique introduced significantly greater intratubular penetration than the cold technique, along with a remarkably superior sealing capacity compared to the cold technique, approaching statistical significance.
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Affiliation(s)
- Gaia D'Amico
- Dentistry degree at the European University of Valencia, Valencia, Spain
| | - Susana Muwaquet Rodriguez
- Restorative dentistry and endodontics, Faculty of Medicine and Dentistry, European University of Valencia, Spain. Catholic University of Valencia, Valencia, Spain. Lecturer
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da Rosa AF, Fischer BV, Dias-Junior LCDL, Serique AVC, Bortoluzzi EA, Teixeira CDS, da Fonseca Roberti Garcia L. Effectiveness of different supplementary protocols for remaining filling material removal in endodontic reintervention: an integrative review. Odontology 2024; 112:51-73. [PMID: 37561273 DOI: 10.1007/s10266-023-00845-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023]
Abstract
The aim of this study was to perform an integrative review to identify the most effective supplementary protocols used after filling material (FM) removal and root canal reinstrumentation, during endodontic reintervention. The literature search was performed on the electronic databases PubMed and Latin American and Caribbean Health Sciences Literature (LILACS), using a combination of specific scientific descriptors. Selection criteria accepted articles published in English, Spanish and Portuguese languages, up to August 2021, involving in vitro and ex vivo studies. After applying the eligibility criteria, 46 articles were included for qualitative analysis. The tool for qualitative analysis of quasi-experimental studies of the Joanna Briggs Institute was used to determine the risk of bias of the included articles. The selected articles provided important data regarding the following supplementary protocols: sonic and ultrasonic activation of the irrigating solution; the use of ultrasonic inserts, XP-endo system instruments, and photon-induced photoacoustic streaming for mechanical debridement; and new devices as GentleWave system, and the self-adjusting file. Overall, all supplementary protocols demonstrated efficacy in removing the remaining FM. The implementation of various supplementary protocols can effectively remove the remaining FM from the root canal walls, although complete removal is not always achieved. However, it was not possible to determine the most effective protocol. Conversely, their association can enhance remaining FM removal. Remaining FM attached to root canal walls hinders proper chemical-mechanical preparation during endodontic reintervention. Supplementary protocols optimize the remaining FM removal, enhancing cleaning and disinfection of root canal.
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Affiliation(s)
- Amanda Freitas da Rosa
- Department of Dentistry - Endodontics Division, Health Sciences Centre, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - Bruna Venzke Fischer
- Department of Dentistry - Endodontics Division, Health Sciences Centre, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - Luiz Carlos de Lima Dias-Junior
- Department of Dentistry - Endodontics Division, Health Sciences Centre, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - Anna Victoria Costa Serique
- Department of Dentistry - Endodontics Division, Health Sciences Centre, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - Eduardo Antunes Bortoluzzi
- Department of Diagnosis & Oral Health, Endodontics Division, University of Louisville, Louisville, KY, USA
| | - Cleonice da Silveira Teixeira
- Department of Dentistry - Endodontics Division, Health Sciences Centre, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - Lucas da Fonseca Roberti Garcia
- Department of Dentistry - Endodontics Division, Health Sciences Centre, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, CEP, Florianópolis, Santa Catarina, 88040-900, Brazil.
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Xue K, Hu G, Wu L, Han H, Sun Y, Gan K, Zhu J, Du T. The bioceramic sealer iRoot SP promotes osteogenic differentiation of human stem cells from apical papilla via miR-141-3p/SPAG9/MAPK signalling pathway. Int Endod J 2023; 56:1241-1253. [PMID: 37357722 DOI: 10.1111/iej.13948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 06/27/2023]
Abstract
AIM The premixed bioceramic sealer iRoot SP that is widely used clinically has been reported to kill bacterial biofilms and promote osteogenic differentiation of human stem cells from the apical papilla (hSCAPs). Although miR-141-3p has been substantiated to be involved in the osteogenic process, the underlying mechanisms remain unclear. The aim of this study was to investigate the role of miR-141-3p in osteogenic differentiation and underlying mechanisms of iRoot SP-treated hSCAPs. METHODOLOGY hSCAPs were extracted from tissue blocks with enzyme digestion and identified by using immunofluorescence, flow cytometry and alizarin red staining. The mRNA expression level of miR-141-3p in hSCPAs after culture with iRoot SP was examined by quantitative real-time PCR (qRT-PCR) assay. SPAG9 was identified as a downstream target gene of miR-141-3p by dual-luciferase report assay. Alkaline phosphatase (ALP) staining and activity detection, alizarin red staining, calcium concentration assay, qRT-PCR and western blot were used to estimate osteogenic differentiation ability and involved protein expression levels of the osteogenic makers and signalling pathway-related factors in iRoot SP-treated hSCAPs. Data were analysed by one-way anova and post hoc Tukey's test to determine any statistical differences between the experimental groups and the control group. p < .05 was considered statistically significant. RESULTS Expression of miR-141-3p was reduced in iRoot SP-treated hSCAPs with the increased exposure time up to 7 days, and the western blot and qRT-PCR results revealed that the osteogenic markers osteocalcin (OCN), osterix (OSX), runt-related transcription factor 2 (RUNX2) and dentin sialophosphoprotein (DSPP) were inversely correlated with miR-141-3p. The negative regulatory relationship between miR-141-3p and SPAG9/ mitogen-activated protein kinases (MAPK) signalling axis was validated in this in vitro experiments. CONCLUSIONS The bioceramic sealer iRoot SP promoted osteogenic differentiation of hSCAPs by inhibiting miR-141-3p following down-regulated SPAG9 expression, and activated MAPK pathway. These findings proposed a novel therapeutic impact of bioceramic sealer iRoot SP inducing bone regeneration in refractory periapical periodontitis.
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Affiliation(s)
- Kaiyang Xue
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Guang Hu
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Laidi Wu
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Han
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuhui Sun
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Kang Gan
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Juanfang Zhu
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Tianfeng Du
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Tan L, Liu Q, Chen Y, Zhao YQ, Zhao J, Dusenge MA, Feng Y, Ye Q, Hu J, Ou-Yang ZY, Zhou YH, Guo Y, Feng YZ. Comparison of sealer penetration of sonic activation versus conventional needle irrigation: a systematic review and meta-analysis of randomized controlled trials. BMC Oral Health 2022; 22:566. [PMID: 36463149 PMCID: PMC9719620 DOI: 10.1186/s12903-022-02608-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/21/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND Most existing studies comparing the efficiency of sonic irrigation (SI) and conventional needle irrigation (CNI) in increasing the penetration of sealers into dentine tubules are controversial; and this study aimed to determine whether the use of SI can lead to greater sealing ability than CNI, during the root canal treatment. METHODS The EMBASE, PubMed, and Cochrane Library databases were used to find confocal laser scanning microscopy studies evaluating percentage and maximum depth of sealer penetration following the use of SI or CNI in mature permanent teeth until October 2022. The critical estimative checklist of randomized controlled trials of the standardized Joanna Briggs Institute was adopted to independently score the quality of each study. The random-effect model for meta-analysis was used to analyse for each canal segment (apical, middle, coronal). The results are shown in the forest plots as weighted mean differences (WMDs) with 95% confidence intervals (95% CIs). RESULTS Ninety-seven articles were included in the preliminary screening, and nine of them were included in this study. Eight studies were included in the meta-analysis.The meta-analysis exhibited great increases in the coronal (WMD: 8.09, 95% CI 2.78-13.40/WMD: 165.32, 95% CI 128.85-201.80), and middle segments (WMD: 8.81, 95% CI 5.76-11.87/WMD: 132.98, 95% CI 68.71-197.25) for the percentage and maximum depth of sealer penetration, respectively. The percentage of sealer penetration in the apical thirds region was nonsignificant (WMD: 4.73, 95% CI - 2.34-11.80). However, the maximum depth of sealer penetration in the apical thirds region was significant (WMD: 121.46, 95% CI 86.55-156.38). Chi-squared analysis revealed heterogeneity scores of 0.0-70.0% and 44.0-90.0% for the percentage and maximum depth of sealer penetration, respectively. DISCUSSION This review verified that SI significantly improves tubular dentin sealer penetration in most areas of the root canal; thus, SI may lead to better filling efficiency and anti-reinfection effects than CNI during and after the root canal therapy. Nevertheless, a large heterogeneity in the current data comparing the irrigation efficiency of SI versus CNI in the apical third of the root canal was found, implying the necessity to standardize root canal irrigation procedures and obtain more accurate results in this area. TRIAL REGISTRATION INPLASY database (INPLASY202270116).
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Affiliation(s)
- Li Tan
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Qiong Liu
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Yun Chen
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Ya-Qiong Zhao
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Jie Zhao
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Marie Aimee Dusenge
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Yao Feng
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Qin Ye
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Jing Hu
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Ze-Yue Ou-Yang
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Ying-Hui Zhou
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China ,grid.452708.c0000 0004 1803 0208National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China
| | - Yue Guo
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Yun-Zhi Feng
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
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Casino Alegre A, Aranda Verdú S, Zarzosa López JI, Plasencia Alcina E, Rubio Climent J, Pallarés Sabater A. Intratubular penetration capacity of HiFlow bioceramic sealer used with warm obturation techniques and single cone: A confocal laser scanning microscopic study. Heliyon 2022; 8:e10388. [PMID: 36097475 PMCID: PMC9463577 DOI: 10.1016/j.heliyon.2022.e10388] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 04/08/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022] Open
Abstract
Objective The aim of this paper was to evaluate the intratubular penetration area of a bioceramic sealer, using continuous wave (CW), vertical condensation (VC) with two different types of gutta-percha (conventional (NG) and bioceramic-coated (BG)) and single cone (SC) technique with BG gutta-percha, in different root thirds. Methods A total of 150 mature single-root human teeth (including incisors, canines and premolars) were prepared and randomly divided into five groups (n = 30). Teeth were filled using a bioceramic sealer (TotalFill BC Sealer HiFlow ®) and two different types of gutta-percha, with CW and VC techniques, the teeth in the control group were filled with SC technique and BG gutta-percha. The teeth were sectioned and evaluated as one-third portions in each case under a confocal laser microscope. The penetration area measurements were carried out with the Autocad ® programme. Data was analyzed using the one-factor ANOVA test (p < 0.05) and Post Hoc Test (p < 0.05). Results The ANOVA Test showed significant differences in the penetration areas of the five obturation techniques (P < 0.05). The Post Hoc Test exhibited significant differences in multiple comparisons (P < 0.05). There was more dentinal tubule penetration in the coronal third than in the apical third in all techniques. Conclusions The intratubular penetration of the bioceramic sealer was influenced by the obturation techniques tested, but not by the different gutta-percha tested. There was more penetration of sealer in the warm obturation techniques than the SC, regardless of the type of gutta-percha used.
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Effect of obturation technique on penetration of calcium silicate-based sealer into dentinal tubules after endodontic retreatment of mandibular premolars. Clin Oral Investig 2022; 26:7143-7148. [PMID: 35972652 DOI: 10.1007/s00784-022-04675-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/10/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Confocal laser scanning microscopy (CLSM) was used to investigate the penetration of endodontic sealers into the dentinal tubules after retreatment using two different obturation techniques. MATERIALS AND METHODS Thirty mandibular premolars were prepared up to instrument F3 (ProTaper Universal, Dentsply) and filled with Endofill using the single cone technique. The canals were retreated using Mtwo instruments. Reobturation was performed with the Bio-C sealer mixed with a fluorophore dye (Fluo-3) using either the lateral condensation technique (group LC) or the single cone technique (group SC) (n = 15). Teeth were sectioned 2, 4, and 6 mm from the apex and analyzed with CLSM to assess the penetration of the sealer into the canal perimeter and the maximum depth of penetration of the sealer into the dentinal tubules. Data were analyzed using ANOVA and the Student-t and Holm-Sidak tests. RESULTS In the apical segment, the penetrated perimeter was significantly higher in the LC group than in the SC group (p < 0.05); no significant difference was found in the middle and cervical segments (p > 0.05). In terms of penetration depth, no significant differences were found for any of the segments studied (p > 0.05). CONCLUSION The LC technique promoted a higher percentage of canal circumference penetrated by the sealer than the SC technique in the apical segment after endodontic retreatment. CLINICAL RELEVANCE CLSM demonstrated that the LC technique promoted a higher percentage of canal perimeter penetrated by the Bio-C sealer than the SC technique in the apical segment of mandibular premolars after retreatment.
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Camilleri J, Atmeh A, Li X, Meschi N. Present status and future directions: Hydraulic materials for endodontic use. Int Endod J 2022; 55 Suppl 3:710-777. [PMID: 35167119 PMCID: PMC9314068 DOI: 10.1111/iej.13709] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hydraulic materials are used in Endodontics due to their hydration characteristics namely the formation of calcium hydroxide when mixing with water and also because of their hydraulic properties. These materials are presented in various consistencies and delivery methods. They are composed primarily of tricalcium and dicalcium silicate, and also include a radiopacifier, additives and an aqueous or a non-aqueous vehicle. Only materials whose primary reaction is with water can be classified as hydraulic. OBJECTIVES Review of the classification of hydraulic materials by Camilleri and the literature pertaining to specific uses of hydraulic cements in endodontics namely intra-coronal, intra-radicular and extra-radicular. Review of the literature on the material properties linked to specific uses providing the current status of these materials after which future trends and gaps in knowledge could be identified. METHODS The literature was reviewed using PUBMED, and for each clinical use, the in vitro properties such as physical, chemical, biological and antimicrobial characteristics and clinical data were extracted and evaluated. RESULTS A large number of publications were retrieved for each clinical use and these were grouped depending on the property type being investigated. CONCLUSIONS The hydraulic cements have made a difference in clinical outcomes. The main shortcoming is the poor testing methodologies employed which provide very limited information and also inhibits adequate clinical translation. Furthermore, the clinical protocols need to be updated to enable the materials to be employed effectively.
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Affiliation(s)
- Josette Camilleri
- School of DentistryCollege of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Amre Atmeh
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM)Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU)DubaiUnited Arab Emirates
| | - Xin Li
- Department of Oral Health SciencesBIOMAT – Biomaterials Research GroupKU Leuven and DentistryUniversity Hospitals LeuvenLeuvenBelgium
| | - Nastaran Meschi
- Department of Oral Health SciencesBIOMAT – Biomaterials Research GroupKU Leuven and DentistryUniversity Hospitals LeuvenLeuvenBelgium
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Biocompatibility of a New Calcium Silicate-Based Root Canal Sealer Mediated via the Modulation of Macrophage Polarization in a Rat Model. MATERIALS 2022; 15:ma15051962. [PMID: 35269193 PMCID: PMC8911908 DOI: 10.3390/ma15051962] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/18/2022] [Accepted: 02/28/2022] [Indexed: 12/16/2022]
Abstract
(1) Background: The EndoSequence BC Sealer HiFlow (Brasseler, Savannah, GA, USA) has recently been introduced in clinical applications. Thus, the aims of the present study are to determine its biocompatibility in vivo and to examine its ability to drive macrophage polarization in vitro and in vivo. (2) Methods: HiFlow was implanted into rat connective tissue for 7, 30 and 150 days. The microstructures and elemental compositions were determined by scanning electron microscopy-energy-dispersive X-ray spectroscopy (SEM-EDX). Hematoxylin–eosin, immunofluorescence, RT–qPCR and flow cytometry were used to elucidate the effects on inflammatory responses and macrophage polarization. (3) Results: SEM-EDX revealed the formation of surface hydroxyapatite crystal layers. Histological evaluation showed that HiFlow exhibited long-term biocompatibility because it decreased inflammatory responses and reduced the number of macrophages over time; however, tissue necrosis was observed in all the groups. RT–qPCR verified that HiFlow regulated the expression of inflammatory factors to inhibit the inflammatory response. Immunofluorescence analysis performed on in vivo samples revealed that HiFlow promoted M2-like macrophage polarization, and these results were confirmed by flow cytometry in vitro. (4) Conclusion: After 150 days of investigation, HiFlow was considered biologically acceptable, and the formation of apatite crystal layers and the promotion of M2-like macrophage polarization may contribute to its favorable biocompatibility.
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Aminoshariae A, Primus C, Kulild JC. Tricalcium silicate cement sealers. J Am Dent Assoc 2022; 153:750-760. [DOI: 10.1016/j.adaj.2022.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/05/2022] [Accepted: 01/09/2022] [Indexed: 01/22/2023]
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Dewi A, Upara C, Sastraruji T, Louwakul P. Effect of a heat-based root canal obturation technique on push-out bond strength of the classical bioceramic and new HiFlow sealer. AUST ENDOD J 2021; 48:116-120. [PMID: 34928534 DOI: 10.1111/aej.12602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 12/01/2022]
Abstract
This study aimed to investigate the effect of the heat-based obturation technique on the push-out bond strength of the classical bioceramic and new HiFlow sealer. Fifty single-rooted human mandibular premolars were obturated using one of the following techniques: (1) BC-SC; (2) BC-W; (3) HiFlow-SC; (4) HiFlow-W; and (5) AH Plus-W. Following obturation, specimens were sectioned into 1-mm-thick root slices 4 and 8 mm from the working length and were subjected to a push-out bond test using a universal testing machine and examined for their modes of failure under an inverted phase-contrast microscope. At both distances tested, there was no difference in the push-out bond strength among the four bioceramic groups (P > 0.05). The AH Plus-W group had lower bond strength than every other group at both distances from the working length. The most common failure mode was mixed failure.
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Affiliation(s)
- Anat Dewi
- Division of Endodontics, Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Chawin Upara
- School of Dentistry, Mae Fah Luang University, Chiang Rai, Thailand
| | | | - Phumisak Louwakul
- Division of Endodontics, Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
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Sinsareekul C, Hiran-Us S. Comparison of the efficacy of three different supplementary cleaning protocols in root-filled teeth with a bioceramic sealer after retreatment-a micro-computed tomographic study. Clin Oral Investig 2021; 26:3515-3521. [PMID: 34854988 DOI: 10.1007/s00784-021-04320-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 11/23/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The present study evaluated the efficacy of three different supplementary cleaning protocols on the removal of bioceramic-based root canal filling materials from oval-shaped canals. MATERIALS AND METHODS A total of 36 human mandibular premolars were instrumented and obturated with gutta-percha and iRoot SP using the single-cone technique. Retreatment was performed with ProTaper Universal retreatment files. The samples were randomly divided into the following supplementary cleaning protocols: conventional syringe irrigation (CSI), passive ultrasonic irrigation (PUI), and XP-endo Finisher R (XPR). The samples underwent micro-CT scanning to quantify the amount of residual filling materials after retreatment and after performing the cleaning protocols. The volume of filling material removal was analyzed by one-way analysis of variance and post hoc Bonferroni and Games-Howell tests (P < 0.05). RESULTS There were significant differences in the amount of root canal filling material removal in every comparison group (P < 0.05). The XPR removed significantly more residual filling materials (P < 0.01) followed by PUI and CSI (P < 0.05). Similar efficacy was found in the total root canal and all root thirds. CONCLUSIONS The additional use of XP-endo Finisher R and passive ultrasonic irrigation effectively removed the bioceramic-obturated root filling materials from the oval-shaped canals. However, none of the techniques completely removed the filling materials. CLINICAL RELEVANCE The XP-endo Finisher R and passive ultrasonic irrigation exhibited greater efficacy compared with syringe irrigation in the reduction of residual filling materials after retreatment in root-filled teeth with a bioceramic sealer.
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Affiliation(s)
- Chanakarn Sinsareekul
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Sirawut Hiran-Us
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand.
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