An in vitro comparison of bond strengths of Gutta-percha/AH Plus, Resilon/Epiphany self-etch and EndoREZ obturation system to intraradicular dentin using a push-out test design

Comparison of the Fracture Resistance of Root-Canal-Treated Premolars Obturated With Dissimilar Materials: An In Vitro Study

Introduction The utilization of endodontic sealers is of paramount importance in ensuring the sustained efficacy and resilience of endodontic treatment. The primary objective of the research was to appraise and contrast the fracture resistance (FR) of three distinct categories of endodontic sealing materials that are frequently employed in the context of endodontic therapy. Materials and methods This research used an in vitro experimental design. Sixty single-rooted human teeth indicated for extraction were utilized according to established protocols. These teeth were then arbitrarily divided into four piles, one for each of the four possible sealants. All specimens were put through a standardized thermal cycling procedure to simulate clinical conditions after the root canals were obturated. The subsequent step involved testing the FR of each group by utilizing a universal testing machine up until failure. Any statistically significant difference in FR among the three sealing materials was identified through appropriate statistical analysis. Results Group 1, which utilized a particular sealing material, exhibited the highest mean fracture resistance, measuring at an impressive 1198.33 ± 321.4 Newtons (N). A post hoc analysis was done to see the exact differences between each group and statistically significant differences between Groups 1 and 2 (p<0.05), Groups 1 and 4 (p<0.05), and Groups 3 and 4 (p<0.001) were observed. Conclusion The FR of Group 1 specimens were noticeably greater than those of Group 2 and Group 4 while the FR of Group 3 specimens was more than that of the Group 4 specimens. This study provides important insights into the fracture resistance of various endodontic sealing materials.

Physicomechanical Properties of Tertiary Monoblock in Endodontics: A Systematic Review and Meta-analysis

Introduction

A systematic review and meta-analysis were conducted to evaluate the physicomechanical properties of tertiary monoblock obturation with different obturation techniques.

Methods and Materials

PubMed (MEDLINE), Web of Science, Scopus, the Cochrane Library, LILACS, IBECS, and BBO were searched time. PICO question was: "In extracted human teeth (Population), does tertiary monoblock obturation (Intervention) have superior physicomechanical properties (Outcome) compared to conventional obturation systems (Comparison)?". Statistical analyses for push-out bond strength were performed with RevMan software by comparing the mean differences of each study, with a 95% confidence interval. Inverse variance was used as statistical method, random-effects models as analysis model, and heterogeneity between studies was assessed by Cochran's Q test and I² statistic (P <0.05).

Results

Of 2162 studies retrieved, 31 were included in this review for "Study Characteristics". Ten studies were included in the meta-analysis. Analysis demonstrated that conventional obturation had significantly higher push-out bond strength than tertiary monoblock obturation (P <0 .01), with a mean difference of -1.00 (95% CI, -1.41 to -0.58; I²=100%). Subgroups using single-cone and cold lateral condensation techniques showed significantly lower push-out bond strength for tertiary monoblock obturation (P <0.01), respectively with a mean difference of -0.09 (95% CI, -1.13 to -0.67; I²=97%) and of -1.97 (95% CI, -3.19 to -0.75; I²=100%). The warm vertical compaction subgroup showed no statistically significant difference between tertiary monoblock and conventional systems (P =0.13), with a mean difference of 0.49 (95% CI, -0.14 to 1.12; I²=10%).

Conclusion

Tertiary monoblock systems have a push-out bond strength similar to conventional systems when used with warm vertical compaction.

Dislodgement resistance and adhesive pattern of different endodontic sealers to dentine wall after artificial ageing: an in-vitro study

To compare the dislodgement resistance and the adhesive pattern of four different endodontic sealers to root dentine walls. Ninety lower premolars were assigned to five groups (n = 18), Group 1: no sealer (control); Group 2: EndoRez (ERZ); Group 3: Sealapex (SPX); Group 4: EndoSeal MTA (ESA) and Group 5: BioRoot RCS (BRS). They were instrumented up to size 30 taper 0.06 and obturated using single cone technique with matched-taper gutta-percha cones and one of the mentioned sealers. Six teeth from each group were then randomly subjected to 100, 1000 and 10,000 thermocycles, respectively. 1 mm slice of mid root region, measuring 6 mm from the apical foramen was prepared and subjected to push-out test under a Universal Testing Machine. Adhesive patterns of sealers were assessed using a stereomicroscope at 20 × magnification and classified using a new system. Statistical analyses were performed using two-way ANOVA, complemented by Tukey HSD and Chi-square tests. ESA and BRS showed significantly higher (p < 0.05) push-out bond strength, followed by SPX, ERZ and lastly the control, but no significant difference was noted between ESA and BRS (p > 0.05) at 100, 1000 and 10,000 thermocycles, respectively. Both ESA and BRS exhibited a significant higher rate (p < 0.05) of Type 3 and Type 4 adhesive patterns as the thermocycles increased. ESA and BRS demonstrated higher bond strength and better adhesive pattern to root dentine wall than SPX and ERZ, especially after artificial ageing.

Experimental Resin-Based Monoblock Endodontic Obturation System

Objective. The aim of the present study was to characterize a novel resin-based monoblock endodontic obturation system consisting of a polymeric cone and a resin-based endodontic sealer. Methods. The preliminary tests performed for the experimental cone were as follows: cohesive strength, dimensional stability, standardization of the diameter and taper, calcium ion release, and radiopacity, for the characterization of the experimental sealer, film thickness and flow tests were performed. Tests were performed according to the American National Standards Institute/American Dental Association (ANSI/ADA) Standards Nos. 57 and 78. The experimental cone was compared to gutta-percha, whereas the experimental sealer was compared to AH Plus. Data were analyzed by Student’s t-test (α = 0.05). Results. The experimental cone had superior values for cohesive strength and dimensional stability compared to gutta-percha. Regarding calcium ion release, the experimental system continued to release calcium ions after 30 days. Film thickness was similar for both endodontic sealers; conversely, the experimental resin-based sealer achieved higher values for flow compared to AH Plus. Conclusion. The experimental resin-based monoblock obturation system fully met the requirements of the ANSI/ADA Standard No. 78 and the ANSI/ADA Standard No. 57, except for radiopacity. Considering this, further studies are still needed to evaluate other radiopacifiers and the effect of their incorporation on the physicochemical properties of this novel resin-based monoblock endodontic obturation system.

Comparison of push-out bond strength of three different obturating systems to intraradicular dentin: An In vitro study

Background:

To increase the push-out bond strength of endodontic materials, newer obturation materials and obturation techniques are being introduced.

Aim:

The present study aimed to evaluate the push-out bond strength of three different obturating materials using a universal testing machine (UTM).

Materials and Methods:

A total of thirty freshly extracted maxillary anterior teeth were collected and randomly divided into three groups of ten each. Biomechanical preparation was done in all the teeth, and they were then divided into three experimental groups according to the obturation material and technique used, as follows: Group I: gutta-percha (GP) with AH Plus root canal sealer (lateral condensation); Group II: thermoplasticized GP technique – noncarrier based (CALAMUS^®) with AH Plus sealer (backfill); and Group III: C-points (self-sealing root canal obturating system) with bioceramic sealer (single cone). Each specimen was subjected to push-out test using the UTM, where the punch moved in an apical to coronal direction at a crosshead speed of 0.5 mm/min, which resulted in the displacement of the filling material. The depth of dye penetration was examined under a stereomicroscope at ×30 magnification.

Results:

All the analyses were performed using SPSS software version 16. P < 0.05 was considered statistically significant. Comparisons of mean values were done using ANOVA with post hoc Games–Howell test and ANOVA with post hoc Tukey's test. Group III demonstrated the highest mean push-out bond strength and Group I exhibited the least bond strength. A statistically significant difference was found between Group III and Group I with regard to the push-out bond strength assessment.

Conclusion:

Push-out bond strength differs among different obturation materials and obturation techniques.

An In vitro Comparison of Pushout Bond Strength of Resilon with MetaSEAL and AH Plus Sealers

Aim

The aim of this study is to evaluate and compare the pushout bond strengths of Resilon with two different sealers: Resilon/MetaSEAL (methacrylate based) and Resilon/AH Plus (an epoxy resin-based sealer).

Materials and Methods

Forty single canal anterior teeth were decoronated at cementoenamel junction and standardized to 10 ± 1 mm length. Working length was determined followed by biomechanical preparation. Then, the specimens were randomly assigned into two groups of 20 teeth each based on the sealer used with Resilon. All canals were obturated using single-cone obturation technique. Root samples were prepared for pushout testing. The universal testing machine gave the debonding force for individual specimen. This was done for all the specimens.

Statistical Analysis

This was done by using unpaired Student's t-test.

Results

The roots filled with Resilon/MetaSEAL had higher bond strength (1.49 ± 0.09 MPa) compared to Resilon/AH Plus (0.90 ± 0.04 MPa) group. The difference in bond strength was statistically significant (P = 0.0000).

Conclusion

Through this pushout bond strength test, it could be noted that MetaSEAL did appear to bond to the dentin and could be used as a potential endodontic sealer.

Efficacy of different irrigation regimes on the push-out bond strength of various resin-based sealers at different root levels: An in vitro study

Aim:

This study aims to evaluate and compare the efficacy of various irrigation regimens on push-out bond strength of AH Plus/gutta-percha, Real Seal/Resilon, and MetaSeal/gutta-percha at three different root levels.

Materials and Methods:

Single-rooted mandibular premolars (n = 120) were prepared and divided into four groups (n = 30) based on irrigation regimen used: I: 5.25% sodium hypochlorite (NaOCl)-17% ethylenediaminetetraacetic acid (EDTA); II: 5.25% NaOCl-2.25% Peracetic acid (PAA); III: 5.25% NaOCl-18% 1-hydroxyethylidene-1, 1-bisphosphonate (HEBP) (Etidronic Acid); and IV: Distilled Water. Each group was further divided into three subgroups (n = 10); A: AH Plus/gutta-percha; B: MetaSEAL/gutta-percha; C: RealSeal/Resilon. After obturation, roots were sectioned at 3 levels and push-out tests were performed. One-way ANOVA with post hoc Tukey-honestly significant difference tests were applied to assess the significance among various groups.

Results:

Among irrigants, 2.25% PAA showed significantly lower values when compared with rest of the irrigants. There was no significant difference found among EDTA and HEBP. The push-out bond strength of AH Plus was significantly higher among all sealers. The bond strength values were significantly decreased in apico-coronal direction.

Conclusions:

There was superior efficacy of EDTA and HEBP on the bond strength of AH Plus at apical root level when compared with other irrigants and sealers at various root levels.

The effect of different root canal sealers on the fracture resistance of endodontically treated teeth-in vitro study

Background:

The aim of this study was to compare the in vitro effects of four different root canal sealers on the fracture resistance of endodontically treated teeth.

Materials and Methods:

Seventy-five freshly extracted human mandibular premolars were used for the study. Teeth were divided into five groups based on type of root canal sealers used. Gutta-percha was used for all the samples: Group I: AH Plus root canal sealer, Group II: MTA Fillapex root canal sealer, Group III: Apexit root canal sealer, Group IV: Conventional zinc oxide-eugenol (ZOE) sealer, Group V: Control (unobturated teeth). The teeth were embedded in acrylic resin blocks and fracture force was measured using a universal testing machine (Asian Test Equipments). Data obtained were statistically evaluated using one-way ANOVA and post hoc test (Tukey's test). All groups showed statistically significant result (P < 0.05).

Results:

Group I and Group II showed higher resistance to fracture than other three groups. There was comparable difference in fracture force between Group I and Group II. Moreover, there was no statistically significant difference between Group III and Group IV and between Group IV and Group V.

Conclusion:

Based on this in vitro study, resin-based sealer was more effective as compared to other sealers and the control group. However, no significant differences were observed between ZOE and control group.

An in vitro Comparison of Bond Strength of Different Sealers/Obturation Systems to Root Dentin Using the Push-Out Test at 2 Weeks and 3 Months after Obturation

OBJECTIVE

To evaluate the push-out bond strength and failure modes of different sealers/obturation systems to intraradicular dentin at 2 weeks and 3 months after obturation compared to AH Plus®/gutta-percha.

MATERIALS AND METHODS

A total of 180 root slices from 60 single-canal anterior teeth were prepared and assigned to 5 experimental groups (n = 36 in each group), designated as G1 (AH Plus®/gutta-percha), G2 (TotalFill BC™ sealer/BC-coated gutta-percha), G3 (TotalFill BC™ sealer/gutta-percha), G4 (EndoREZ® sealer/EndoREZ®-coated gutta-percha), and G5 (EndoREZ® sealer/gutta-percha). Push-out bond strengths of 18 root slices in each group were assessed at 2 weeks and the other 18 at 3 months after obturation using a universal testing machine. Data were analyzed using repeated measures ANOVA. An independent t test was used to compare the mean push-out bond strength for each group at 2 weeks and 3 months after obturation.

RESULTS

The mean push-out bond strengths of G4 and G5 were significantly lower than those of G1, G2, and G3 (p < 0.05) at both 2 weeks (G1: 1.46 ± 0.29 MPa, G2: 1.74 ± 0.43 MPa, G3: 1.74 ± 0.43 MPa, G4: 0.66 ± 0.31 MPa, G5: 0.74 ± 0.47 MPa) and 3 months after obturation (G1: 1.70 ± 1.05 MPa, G2: 3.69 ± 1.20 MPa, G3: 2.84 ± 0.83 MPa, G4: 0.14 ± 0.05 MPa, G5: 0.24 ± 0.10 MPa). The mean push-out bond strengths of G2 (3.69 ± 1.20 MPa) and G3 (2.84 ± 0.83 MPa) were higher at 3 months compared to 2 weeks after obturation (G2: 1.74 ± 0.43 MPa, G3: 1.33 ± 0.29 MPa).

CONCLUSION

The TotalFill BC™ obturation system (G2) and the TotalFill BC™ sealer/gutta-percha (G3) showed comparable bond strength to AH Plus®. Their bond strength increased over time, whereas the EndoREZ® obturation system (G4) and EndoREZ sealer (G5) had low push-out bond strength which decreased over time.

Comparison of bond strength of different endodontic sealers to root dentin: An in vitro push-out test

Aim:

To compare the bond strength of four different endodontic sealers to root dentin through push-out test design.

Materials and Methods:

Forty single-rooted teeth with completely formed apices were selected. Teeth were decoronated, and working length was determined. Instrumentation and irrigation were performed. The teeth were divided into four groups based upon the sealer used. Group 1: Bioceramic sealer (Endosequence), Group 2: Mineral trioxide aggregate (MTA) based sealer (MTA Fill apex), Group 3: Epoxy resin based sealer (MM-Seal), and Group 4: Dual cure resin-based sealer (Hybrid Root Seal). Manipulation and application of the sealer was done as per the manufacturer instructions. All the teeth were obturated using 6% gutta-percha. After obturation, each tooth was prepared for push-out test with root slices of 2 mm thickness using universal testing machine.

Results:

The highest bond strength was found in Group 1 (Endosequence) (P < 0.05) compared to other groups. The lowest bond strength was found in Group 2 (MTA Fill apex). Statistical analysis is done by two-way ANOVA and Newman-Keuls multiple post hoc.

Conclusion:

The push-out bond strength of Bioceramic sealer was highest followed by resin-based sealer and lowest bond strength was observed in MTA-based sealer.

Push-out bond strength and dentinal tubule penetration of different root canal sealers used with coated core materials

Objectives

The aim of this study was to compare the push-out bond strength and dentinal tubule penetration of root canal sealers used with coated core materials and conventional gutta-percha.

Materials and Methods

A total of 72 single-rooted human mandibular incisors were instrumented with NiTi rotary files with irrigation of 2.5% NaOCl. The smear layer was removed with 17% ethylenediaminetetraacetic acid (EDTA). Specimens were assigned into four groups according to the obturation system: Group 1, EndoRez (Ultradent Product Inc.); Group 2, Activ GP (Brasseler); Group 3, SmartSeal (DFRP Ltd. Villa Farm); Group 4, AH 26 (Dentsply de Trey)/gutta-percha (GP). For push-out bond strength measurement, two horizontal slices were obtained from each specimen (n = 20). To compare dentinal tubule penetration, remaining 32 roots assigned to 4 groups as above were obturated with 0.1% Rhodamine B labeled sealers. One horizontal slice was obtained from the middle third of each specimen (n = 8) and scanned under confocal laser scanning electron microscope. Tubule penetration area, depth, and percentage were measured. Kruskall-Wallis test was used for statistical analysis.

Results

EndoRez showed significantly lower push-out bond strength than the others (p < 0.05). No significant difference was found amongst the groups in terms of percentage of sealer penetration. SmartSeal showed the least penetration than the others (p < 0.05).

Conclusions

The bond strength and sealer penetration of resin-and glass ionomer-based sealers used with coated core was not superior to resin-based sealer used with conventional GP. Dentinal tubule penetration has limited effect on bond strength. The use of conventional GP with sealer seems to be sufficient in terms of push-out bond strength.

Evaluation of fracture resistance of roots obturated with resilon and thermoplasticized gutta-percha: An in vitro study

Aim:

To investigate and compare the fracture resistance of resilon and realseal filled root canals with those that were obturated with thermoplasticized gutta-percha and AH-plus endodontic sealer.

Materials and Methods:

Eighty extracted human mandibular single-rooted premolars stored in 10% formalin were used in this study. They were prepared by using a crown-down technique, debrided and irrigated with NaOCl, EDTA, and normal saline and divided into four groups. Group I = Negative control, canals prepared but no obturation was done; Group II = Positive control obturated with dual cure composite resin; Group III = Obturated with thermoplasticized GP and AH-plus; Group IV = Obturated with resilon and realseal. All root specimens were stored for two weeks in 100% humidity to allow for complete setting of the sealer. Each specimen was mounted in acrylic in a polyvinyl ring and tested for fracture resistance with a universal testing machine. The loading fixture of the machine was mounted with its spherical tip aligned with the center of the access opening of each root. A vertical loading force was applied until it fractured the root. The force values were subjected to statistical analysis: Kruskall-Wallis H-test and Mann-Whitney U-test.

Results:

Group comparison revealed that Group II (positive control) had significantly higher values of resistance to fracture as compared to all the other groups. While Group IV (resilon with realseal) had significantly higher values of resistance to fracture as compared to Group I (negative control).

Conclusion:

On the basis of our findings, it can be concluded that filling the root canals with resilon and realseal increased the in vitro resistance to fracture of single-canal extracted teeth. resilon and realseal demonstrated high fracture-resistance values and could be an alternative to the conventional gutta-percha.

Does acid etching enhance remineralisation of arrested white spot lesions?

AIM

To investigate the effect of acid etching procedure on the remineralisation of white spot lesions (WSL) which had undergone an initial phase of arrest, and to compare between the effect of fluoride and/or CPP-ACP on remineralisation before and after acid etching.

STUDY DESIGN

In vitro study.

METHODS

WSL were prepared in vitro on 130 human enamel slabs which were allocated into four experimental groups (N = 30) and one control group (N = 10). Changes in mineral content were registered weekly by Quantitative Light Induced Fluorescence QLF. When changes had arrested (after 8 weeks), the enamel surface of 20 slabs in each group were acid etched. The remineralisation process was continued until it slowed down again (after 5 weeks).

RESULTS

Mean fluorescence gain was 13.7 ± 0.9% in the fluoride group, 16.5 ± 1.1% in the CPP-ACP group, and 11.4 ± 1.2% in the combination of fluoride and CPP-ACP group.

CONCLUSIONS

There was a tendency toward better remineralisation after acid etching but this did not reach a significant level; the effect of etching was more pronounced in the presence of fluoride. Although CPP-ACP seemed to give a steadier rate of remineralisation over time when compared with fluoride, the overall remineralisation in the regimens was similar. In this model, combined treatment of fluoride and CPP-ACP did not have an extra benefit over the fluoride or CPP-ACP alone.

Epiphany sealer penetration into dentinal tubules: Confocal laser scanning microscopic study

AIMS

The aim of the following study was to evaluate the percentage and average depth of epiphany sealer penetration into dentinal tubules among the coronal, middle and apical thirds of the root using the confocal laser scanning microscopy (CLSM).

MATERIALS AND METHODS

A total of 10 maxillary central incisors were prepared and obturated with Resilon-Epiphany system. Sealer was mixed with fluorescent rhodamine B isothiyocyanate dye for visibility under confocal microscope. Teeth were cross-sectioned into coronal, middle and apical sections-2 mm thick. Sections were observed under CLSM. Images were analyzed for percentage and average depth of sealer penetration into dentinal tubules using the lasso tool in Adobe Photoshop CS3 (Adobe systems incorporated, San jose, CA) and laser scanning microscopy (LSM 5) image analyzer.

STATISTICAL ANALYSIS USED

One-way analysis of variance with Student Neuman Keuls post hoc tests, Kruskal-Wallis test and Wilcoxon signed-rank post hoc tests.

RESULTS

The results showed that a higher percentage of sealer penetration in coronal section-89.23%, followed by middle section-84.19% and the apical section-64.9%. Average depth of sealer penetration for coronal section was 526.02 μm, middle-385.26 μm and apical-193.49 μm.

CONCLUSIONS

Study concluded that there was higher epiphany sealer penetration seen in coronal followed by middle and least at apical third of the roots.

Push-out bond strength of self-adhesive methacrylate resin-based sealers to root dentin

This study examined the adhesive strength of two self-adhesive methacrylate resin-based sealers (MetaSEAL and RealSeal SE) to root dentin and compared them with RealSeal and AH Plus in properties. A total of 48 extracted human single-rooted teeth were used to prepare the 0.9-mm thick longitudinal tooth slice (each per tooth). Standardized simulated canal spaces of uniform dimensions were prepared in the middle of radicular dentin. After treated with 5.25% sodium hypochlorite (NaOCl) and 17% EDTA, tooth slices were allocated randomly to four groups (n=12) in terms of different sealers used: MetaSEAL, RealSeal SE, RealSeal, and AH plus groups. The simulated canal spaces were obturated with different sealers in each group. There were 10 slabs with 20 simulated canal spaces (n=20) used in each group for push-out testing. The failure modes and the ultrastructures of fractured sealer-dentin interfaces were examined. The remaining 2 slabs in each group underwent partial demineralization for observation of the ultrastructure of resin tags. The results showed that the push-out bond strength was 12.01±4.66 MPa in MetaSEAL group, significantly higher than that in the other three groups (P<0.05). Moreover, no statistically significant differences were noted in the push-out bond strength between RealSeal SE (5.43±3.68 MPa) and AH Plus (7.34±2.83 MPa) groups and between RealSeal SE and RealSeal (2.93±1.76 MPa) groups (P>0.05). Mixed failures were predominant in the fractured sealer-dentin interfaces in MetaSEAL and AH Plus groups, while adhesive failures were frequently seen in RealSeal SE and RealSeal groups. In conclusion, after complete removal of the smear layer, MetaSEAL showed superior bond ability to root dentin. The RealSeal SE is applicable in clinical practice, with its adhesive strength similar to that of AH Plus. The self-adhesive methacrylate resin-based sealer holds promise for use in endodontic treatment.