A laboratory comparison of apical leakage between immediate versus delayed post space preparation in root canals filled with Resilon

Immediate and Delayed Post Space Preparations in Endodontically Treated Teeth: A Scoping Review

BACKGROUND

The aim of the present review was to identify the effect of the post-space preparation (PSP) timing (immediate or delayed) on endodontically treated teeth.

METHODS

All studies in any language that compared the effect of immediate versus delayed PSP on the outcomes of an endodontically treated tooth were searched in PubMed, Scopus, Web of Science, Cochrane, ProQuest, WorldCat, and Google Scholar databases by two independent researchers until February 12, 2022. Studies assessing merely the immediate or delayed PSP were excluded. A descriptive analysis was performed to evaluate the study design and the characteristics of the included studies.

RESULTS

The initial search yielded 2612 records, of which 68 were included. Except for one randomized controlled trial, all were in vitro. The evaluated variables were apical/coronal microleakage (n = 48/n = 1), post-bond strength (n = 8), bacterial infiltration (n = 7), presence of voids (n = 3), apical extrusion and residual of filling material (n = 1), and post-operative pain (n = 1). The number of publications had steady growth per year and fast growth per decade. "Post-space preparation" was the most popular keywords.

CONCLUSIONS

The present review highlights the need for further investigations due to the various design of studies, controversial results, and an inadequate number of randomized controlled trials.

TRIAL REGISTRATION

Retrospectively registered. Open Science ( https://doi.org/10.17605/OSF.IO/2YTM6 ).

Comparison of the effect of post space preparation time on the apical seal of two different sealers

BACKGROUND

The present study compared the effect of post space preparation time on the apical seal of two different sealers.

METHODS

In the in vitro study, 94 central incisors were used. After the samples' root canal preparation, they were randomly assigned to four experimental groups (n = 21). The samples in groups 1 and 2 were obturated with AH Plus sealer, gutta-percha, and in groups 3 and 4 with Endoseal MTA bioceramic sealer and single cone technique. The post spaces in groups 1 and 3 were prepared immediately and in groups 2 and 4 with a delay. The samples were evaluated at 7-, 30-, and 90-day intervals for apical microleakage using the fluid filtration technique. The data were analyzed with SPSS 25, using three-way ANOVA and independent t-test.

RESULTS

The apical microleakage in groups 3 and 4, obturated with Endoseal MTA bioceramic sealer and prepared immediately and after a delay, respectively, was not significantly different between the interval times. In group 2, obturated with AH Plus sealer and prepared for post space with a delay, the apical microleakage was significantly less than all the other groups. Group 1, obturated with AH Plus sealer and prepared for post space immediately, exhibited the least microleakage after seven days, but its microleakage increased over time to reach the level of groups 3 and 4.

CONCLUSION

According to the results, the apical microleakage in the AH + sealer group and the delayed post-space preparation method, was significantly less than all the other groups over time.

Bacterial microleakage in endodontically treated teeth following two methods of postspace preparation at two-time intervals: An in vitro study

Aims

The goal of this study was to analyze the bacterial microleakage following two methods (heat vs. rotary) of postspace preparation after two-time intervals (immediate vs. 1 week later).

Setting and Design

In vitro-comparative study.

Materials and Methods

Eighty-two single-rooted teeth were decoronated at the cementoenamel junction. Root canals were prepared using rotary files. After root canal obturation, specimens were randomly allocated to 4 experimental groups based on the method of postspace preparation (heat or peeso reamer) and time interval (immediate or 1 week later) (n = 18). Group 1: Peeso reamer-immediate, Group 2: Heat-immediate, Group 3: Peeso reamer-1 week later, Group 4: Heat-1 week later. 10 specimens were considered as positive and negative controls (n = 5 each). Custom-made dual-chamber devices were used to appraise the bacterial microleakage for 60 days.

Statistical Analysis Used

Data were analyzed with Chi-Square and Log-Rank tests and Cox regression.

Results

All through the experimental period, there was no significant difference (P = 0.41) between the studied groups. Groups 2 and 4 had the highest microleakage and the lowest survival rate (55.56% ± 11.71%). Group 1 showed the lowest microleakage and the highest survival rate (77.8% ± 9.80%).

Conclusions

The applied techniques for postspace preparation and the time intervals (neither independently nor simultaneously) showed no significant difference in the field of bacterial leakage.

Evaluation of apical leakage after immediate and delayed postspace preparation using different root canal sealers: An in vitro study

Background

Endodontically treated teeth with extensive loss of tooth structure lacks sufficient support for a permanent restoration. While restoring them with post and core it is important not to disrupt the apical seal.

Aim

Evaluation of apical leakage after immediate and delayed postspace preparation using two root canal sealers.

Materials and Methods

Sixty single-rooted teeth were decoronated and roots were biomechanically prepared and obturated with gutta-percha and 2 sealers: AH Plus (Group A, n = 30) and Sure-Seal root canal sealer (Group B, n = 30). Groups A and B were subdivided into A1, A2 and B1, B2. Postspace was prepared immediately for A1 and B1. For A2 and B2 post space was prepared after storage in physiologic saline for 1 week. The samples were kept in Rhodamine B dye for 72 h and then sectioned longitudinally to observe dye penetration along the root canal wall under Stereomicroscope. The dye penetration was measured linearly and the values were subjected for statistical analysis using one-way analysis of variance and t-test.

Results

Statistically significant difference between Group A (1.00 mm) and B (2.71 mm) was observed (P < 0.001). However, the subgroups for immediate and delayed post space preparation did not show statistically significant difference (A1 = 0.947; A2 = 1.043; B1 = 2.306 and B2 = 3.120, P < 0.001).

Conclusion

AH plus sealer showed lesser leakage compared to Sure-Seal Root canal sealer. The difference in leakage values was not statistically significant in delayed and immediate post space preparation groups, Time of postspace preparation has no influence on apical leakage.

Comparison between immediate and delayed post space preparations: a systematic review and meta-analysis

OBJECTIVES

This systematic review and meta-analysis compared the effects of immediate and delayed post space preparation on apical sealing.

MATERIALS AND METHOD

Two independent authors conducted a systematic search (PubMed/Medline, Cochrane Library, and other databases, until February 2020) and a risk of bias evaluation. Only in vitro studies that compared the effects of immediate and delayed post space preparations on apical filling and adhesion of the post were eligible.

RESULT

Of the 742 articles retrieved, 32 were included. Most of the studies used single-rooted human teeth and rotary files for root canal preparation, a single-cone technique for the filling protocol, and rotary instruments for post space preparation. Various delayed preparation times were evaluated: 8-72 h, 5-30 days (mainly 7 days), and 4 months. In nine studies, the delayed groups showed more apical leakage, while four studies reported more leakage in the immediate groups; ten studies found no significant difference. One study found more bacterial penetration in the delayed group, whereas three studies showed no significant difference. One study reported more voids in the delayed group, while another found no such difference. Three studies showed better post-bond strength in the delayed group, one in the immediate group, whereas three found no significant difference in post-bond strength. Three studies employing varied sealers for root canal fillings were considered for meta-analysis. Two subgroup analyses were also performed (one concerning the use of resin-based sealers (AH Plus), another for zinc oxide-eugenol-based sealers). The results of the meta-analysis showed that a delayed post space preparation led to a significantly higher apical leakage than an immediate preparation (mean difference = 0.41 mm, confidence interval = 0.24-0.59, p < 0.001).

CONCLUSION

Delayed post space preparation seems to negatively influence apical sealing; however, further studies are needed to determine the influence of the timing of post space preparation on the other parameters.

CLINICAL RELEVANCE

Immediate post space preparation may be the safest clinical choice to prevent apical leakage.

Microbiological Study of Cast Posts before Cementation

This study identifies the most common microorganisms present in type III gold cast posts related to pulpal disease and evaluates the sterilization/disinfection method before cementation in the root canal. Forty-five type III gold cast posts were aseptically collected in sterile sealed plastic bags and taken to the microbiology laboratory to carry out the study: fifteen cast posts had no treatment, fifteen were disinfected (immersion in 70% alcohol during 15 minutes), and fifteen were autoclaved at 121°C for 15 minutes by using saturated steam under 15 psi pressure. By using a two-proportion z-test, the difference was statistically significant (p > 0.05) and demonstrates that, in spite of the aseptic pattern used in the cast post collection and laboratory procedures, some cast posts arrive contaminated at the consulting office. The disinfection process worked out in a high percentage and demonstrated that the sterilization by autoclaving eliminated completely the pathogenic microbiota without affecting the cast post shape and integrity that could compromise their final fitting.

Resilon: Review of a New Material for Obturation of the Canal

Resilon is a thermoplastic synthetic polymer-based endodontic material alternative to gutta-percha. It contains bioactive glass and also radiopaque fillers. It has the same handling properties as gutta-percha. For endodontic retreatment, it may be dissolved with some solvents, such as chloroform or softened with heat. The composition of Resilon and its sealer (Epiphany) bond to dentin and form a monoblock. A review of the literature and a discussion of its properties comparing to other root canal filling materials are presented.

Resilon: a comprehensive literature review

Background and aims. An ideal root canal filling material should completely seal the entire root canal space and block communication between the root canal system and its surrounding tissues; it should also be nontoxic, noncarcinogenic, non-genotoxic, biocompatible, insoluble in tissue fluids and dimensionally stable. Bonding to dentin is a promising property, which can prevent leakage and improve the sealing ability of root canal filling materials. Resilon was developed and rec-ommended initially because the existing rootcanal filling materials did not bond to root canal dentin. Since its introduction in 2004, numerous reports have been published regarding various aspects of this material. The aim of this literature review is to present investigations regarding Resilon's physical and chemical properties and leakage studies. Materials and methods. A review of the literature was performed by using electronic and hand searching methods for Resilon from May 2004 to April 2012. Results. There are many published reports regarding Resilon. The searchshowed that Resilon is composed of a parent polymer, polycaprolactone or Tone, which is a biodegradable aliphatic polyester, with filler particles consisting of bioactive glass, bismuth oxychloride and barium sulfate. It possesses some antibacterial and antifungal properties. It is a promising material for root canal filling. Despite the presence of numerous case reports and case series regarding these applications, there are few designed research studies on clinical applications of this material. Resilon has some drawbacks such as high cost. Conclusion. Resilon seals well and is a biocompatible material. However, more clinical studies are needed to confirm its efficacy compared with other materials.