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Azizi H, Hadad A, Levy DH, Ben Itzhak J, Kim HC, Solomonov M. Epoxy vs. Calcium Silicate-Based Root Canal Sealers for Different Clinical Scenarios: A Narrative Review. Dent J (Basel) 2024; 12:85. [PMID: 38667997 PMCID: PMC11048901 DOI: 10.3390/dj12040085] [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: 01/02/2024] [Revised: 03/02/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
This study aimed to review the considerations for choosing a suitable sealer according to various endodontic scenarios. An electronic search of PubMed, Scopus, and the Web of Science was undertaken for the keywords of 'sealer choosing', 'appropriate sealer', 'suitable sealer', 'sealer for clinical scenario', and 'sealer for clinical situations'. However, the literature review revealed a lack of studies with practical clinical recommendations regarding the choice of appropriate endodontic root canal sealers for particular clinical situations of root canal treatment. Therefore, a narrative review was undertaken under the basis of the characteristics of an epoxy resin-based sealer (ERS) versus a calcium silicate-based sealer (CSS). Based on the evidence found through the review, the choice of an appropriate sealer in a variety of clinical scenarios was proposed. An ERS is recommended for one-visit non-vital cases, teeth with periodontal involvement, cracked teeth, and internal root resorption without root perforation. A CSS is recommended for vital or non-vital cases in multiple visits, teeth with internal root resorption with perforation or internal approach for external cervical resorption, teeth with open apices, and teeth with iatrogenic aberrations.
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Affiliation(s)
- Hadas Azizi
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Avi Hadad
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dan Henry Levy
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Joe Ben Itzhak
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan 46241, Republic of Korea;
| | - Michael Solomonov
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat-Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Ortega MA, Rios L, Fraile-Martinez O, Liviu Boaru D, De Leon-Oliva D, Barrena-Blázquez S, Pereda-Cerquella C, Garrido-Gil MJ, Manteca L, Buján J, García-Honduvilla N, García-Montero C, Rios-Parra A. Bioceramic versus traditional biomaterials for endodontic sealers according to the ideal properties. Histol Histopathol 2024; 39:279-292. [PMID: 37747049 DOI: 10.14670/hh-18-664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Odontology, as a scientific discipline, continuously collaborates with biomaterials engineering to enhance treatment characteristics and patients' satisfaction. Endodontics, a specialized field of dentistry, focuses on the study, diagnosis, prevention, and treatment of dental disorders affecting the dental pulp, root, and surrounding tissues. A critical aspect of endodontic treatment involves the careful selection of an appropriate endodontic sealer for clinical use, as it significantly influences treatment outcomes. Traditional sealers, such as zinc oxide-eugenol, fatty acid, salicylate, epoxy resin, silicone, and methacrylate resin systems, have been extensively used for decades. However, advancements in endodontics have given rise to bioceramic-based sealers, offering improved properties and addressing new challenges in endodontic therapy. In this review, a classification of these materials and their ideal properties are presented to provide evidence-based guidance to clinicians. Physicochemical properties, including sealing ability, stability over time and space, as well as biological properties such as biocompatibility and antibacterial characteristics, along with cost-effectiveness, are essential factors influencing clinicians' decisions based on individual patient evaluations.
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Affiliation(s)
- Miguel A Ortega
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain.
- Cancer Registry and Pathology Department, Principe de Asturias University Hospital, Alcala de Henares, Spain
| | - Laura Rios
- Universidad San Pablo CEU, Madrid, Spain
| | - Oscar Fraile-Martinez
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Diego Liviu Boaru
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
| | - Diego De Leon-Oliva
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
| | - Silvestra Barrena-Blázquez
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Claude Pereda-Cerquella
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
| | - Maria J Garrido-Gil
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
| | | | - Julia Buján
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Natalio García-Honduvilla
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Cielo García-Montero
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain.
| | - Antonio Rios-Parra
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Cancer Registry and Pathology Department, Principe de Asturias University Hospital, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
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Okamoto M, Naito K, Duncan HF, Kinomoto Y, Kuriki N, Miura J, Mizuhira M, Suzuki M, Hayashi M. Microstructural Evaluation of the Mineralized Apical Barrier Induced by a Calcium Hydroxide Paste Containing Iodoform: A Case Report. J Endod 2024; 50:243-251. [PMID: 37918795 DOI: 10.1016/j.joen.2023.10.013] [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: 08/30/2023] [Revised: 10/25/2023] [Accepted: 10/25/2023] [Indexed: 11/04/2023]
Abstract
INTRODUCTION A 65-year-old man had nonsurgical retreatment using an iodoform and calcium hydroxide paste in a maxillary left canine with persistent apical periodontitis. An apical mineralized barrier (AMB) was observed 3-months postoperatively. Unfortunately, the tooth was extracted due to a cementum tear. This provided an opportunity to analyze the AMB histologically, as there is a lack of previous reports on its microstructure. METHODS After extraction and removal of the granulation tissue from the root surface, the canine was processed, and observed using micro-computed tomography (μCT) and light microscopy. Thereafter, the specimen was resin-embedded specimen was evaluated by scanning electron microscopy, micro-X-ray fluorescence spectroscopy and Raman spectroscopy to understand the mechanism and nature of the AMB formation during apical healing. RESULTS Nonsurgical retreatment was clinically successful based on the absence of clinical symptoms of apical periodontitis and the radiographic presence of an AMB. The AMB was opaque and could be readily differentiated from dentin under a light microscope. Micro-computed tomography analysis revealed that the AMB had the same mineral density as dentin. Scanning electron microscopy revealed that the AMB had two distinct layers based on the size of the calcified particles. Elemental mapping using micro-X-ray fluorescence spectroscopy showed that the localization of calcium and phosphorus differed between AMB and other areas of biomineralization. Raman spectral mapping revealed that the surface layer of the AMB consisted of collagen, calcium carbonate, and hydroxyapatite. CONCLUSIONS This study explored new analytical methods for elucidating the apical wound-healing process and the nature of the mineralized repair. The findings provided detailed information on the AMB highlighting a bilaminar structure with high calcium components higher on the inside and a brightness similar to cementum not dentin and the presence of hydroxyapatite.
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Affiliation(s)
- Motoki Okamoto
- Department of Oral Science and Translational Research, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida; Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan.
| | - Katsuaki Naito
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Henry Fergus Duncan
- Division of Restorative Dentistry & Periodontology, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | - Yoshifumi Kinomoto
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Nanako Kuriki
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Jiro Miura
- Division for Interdisciplinary Dentistry, Osaka University Dental Hospital, Osaka, Japan
| | - Manabu Mizuhira
- Bruker Japan K.K. Nano Analytics Division, Yokohama, Kanagawa, Japan
| | - Maiko Suzuki
- Department of Oral Science and Translational Research, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida
| | - Mikako Hayashi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
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Hamdy TM, Galal MM, Ismail AG, Saber S. Physicochemical properties of AH plus bioceramic sealer, Bio-C Sealer, and ADseal root canal sealer. Head Face Med 2024; 20:2. [PMID: 38172921 PMCID: PMC10765876 DOI: 10.1186/s13005-023-00403-z] [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: 08/14/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The aim of this study was to evaluate the physicochemical properties of two newly introduced premixed calcium silicate-based root canal sealers (AH Plus Bioceramic Sealer and Bio-C Sealer) compared to a resin-based root canal sealer (ADseal root canal sealer). METHODS Solubility, pH analysis, calcium ion release, and film thickness of each sealer were evaluated following ISO guidelines. The data were examined using the two-way ANOVA test. Furthermore, X-ray diffraction (XRD) examination was performed to investigate the crystalline phase of each type of sealer. X-ray fluorescence (XRF) analysis was done for the chemical elemental analysis of each sealer. RESULTS The least film thickness, highest alkalinity, and highest calcium ion release were all displayed by AH Plus Bioceramic Sealer. High solubility, high alkalinity, intermediate calcium ion release, and intermediate film thickness were all displayed by Bio-C Sealer. While ADseal root canal sealer displayed the greatest film thickness, least solubility, alkalinity, and calcium ion release. CONCLUSIONS Both AH Plus Bioceramic Sealer and Bio-C Sealer represented adequate properties to be considered a good sealer that could be used as a potential alternative to resin-based root canal sealers.
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Affiliation(s)
- Tamer M Hamdy
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt.
| | - Manar M Galal
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt
| | - Amira Galal Ismail
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt
| | - Shehabeldin Saber
- Endodontic Department, Faculty of Dentistry, The British University in Egypt, Cairo, 11841, Egypt
- Center for Innovative Dental Sciences, The British University in Egypt, Cairo, 11841, Egypt
- Endodontic Department, Faculty of Dentistry, Ain Shams University, Cairo, 11566, Egypt
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Washio A, Kérourédan O, Tabata Y, Kokabu S, Kitamura C. Effect of Bioactive Glasses and Basic Fibroblast Growth Factor on Dental Pulp Cells. J Funct Biomater 2023; 14:568. [PMID: 38132822 PMCID: PMC10744375 DOI: 10.3390/jfb14120568] [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: 10/17/2023] [Revised: 12/15/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
Ideal regeneration of hard tissue and dental pulp has been reported with the use of a combination of bioactive glass and basic fibroblast growth factor (bFGF). However, no previous study has investigated the molecular mechanisms underlying the processes induced by this combination in dental pulp cells. This study aimed to examine the cellular phenotype and transcriptional changes induced by the combination of bioactive glass solution (BG) and bFGF in dental pulp cells using phase-contrast microscopy, a cell counting kit-8 assay, alkaline phosphatase staining, and RNA sequence analysis. bFGF induced elongation of the cell process and increased the number of cells. Whereas BG did not increase ALP activity, it induced extracellular matrix-related genes in the dental pulp. In addition, the combination of BG and bFGF induces gliogenesis-related genes in the nervous system. This is to say, bFGF increased the viability of dental pulp cells, bioactive glass induced odontogenesis, and a dual stimulation with bioactive glass and bFGF induced the wound healing of the nerve system in the dental pulp. Taken together, bioactive glass and bFGF may be useful for the regeneration of the dentin-pulp complex.
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Affiliation(s)
- Ayako Washio
- Division of Endodontics and Restorative Dentistry, Department of Oral Functions, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu 803-8580, Japan;
| | - Olivia Kérourédan
- National Institute of Health and Medical Research (INSERM), U1026 BIOTIS, University of Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France;
| | - Yasuhiko Tabata
- Laboratory of Biomaterials, Department of Regeneration Science and Engineering, Institute for Frontier Life and Medical Sciences, Kyoto University, 53 Kawara-cho Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;
| | - Shoichiro Kokabu
- Division of Molecular Signaling and Biochemistry, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu 803-8580, Japan;
| | - Chiaki Kitamura
- Division of Endodontics and Restorative Dentistry, Department of Oral Functions, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu 803-8580, Japan;
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Janini ACP, Pelepenko LE, Boldieri JM, dos Santos VAB, da Silva NA, Raimundo IM, Gomes BPFA, Marciano MA. Biocompatibility analysis in subcutaneous tissue and physico-chemical analysis of pre-mixed calcium silicate–based sealers. Clin Oral Investig 2023; 27:2221-2234. [PMID: 36977761 DOI: 10.1007/s00784-023-04957-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/17/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVES To evaluate the biocompatibility, physical and chemical properties of three pre-mixed calcium silicate-based sealers and an epoxy resin-based material were assessed. Pre-mixed sealers supposedly obtain water from the root canal moist to hydrate and set. MATERIALS AND METHODS Polyethylene tubes were filled with the materials Bio-C Sealer Ion+, Bio-C Sealer, EndoSequence BC Sealer and AH Plus Jet, or left empty and surgically implanted in the subcutaneous tissue of Wistar rats. The animals were euthanised and the tubes and tissue were removed for histological analysis and scanning electron microscopy (SEM) coupled with energy-dispersive spectrometry (EDS). Materials' surface chemical characterisation was assessed using Raman spectroscopy and SEM/EDS. Flow, setting time (in two conditions), solubility, radiopacity and pH were also analysed. ANOVA and Bonferroni correction were performed for comparisons (P < 0.05). RESULTS Inflammatory response observed in the tissues subsided from 7 to 30 days. Tungsten migration could be detected in the surrounding tissue following AH Plus Jet implantation. All calcium silicate-based sealers exhibited zirconium oxide (radiopacifier) and tricalcium silicate peaks before and after implantation. All materials exhibited flow values above 17 mm. An approximately tenfold difference was observed between the plaster- and metal-mould setting times of the calcium silicate cements indicating its sensitivity to moist variations and solubility above 8% was also observed for these materials. CONCLUSIONS Pre-mixed materials exhibited variable setting time and solubility with a decreasing inflammatory response. CLINICAL RELEVANCE The variable moist-dependant setting time with high solubility poses a concern for the clinical use of these pre-mixed sealers.
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