Ex vivo microbial leakage analysis of polytetrafluoroethylene tape and cotton pellet as endodontic access cavity spacers

Assessing correlation between different temporary restorative materials for microleakage following endodontic treatment: an in-vitro study

BACKGROUND

Coronal microleakage, the passage of fluids and bacteria through the interface between the temporary restoration and the tooth structure, can potentially result in endodontic treatment failure.

PURPOSE

This study evaluated and compared the sealing efficacy of various temporary restorative materials utilized during endodontic procedures.

METHODS

All seventy premolar teeth were extracted, measured, and restored, except for the negative control group, where the teeth were left whole. There were eight distinct groupings created from the teeth. Sound teeth were utilized in the n = 5 (Group 1) negative control group. A cavity after endodontic treatment was left vacant in the positive control group (n = 5, Group 2). Six experimental groups, each with ten specimens, had access cavities restored using various temporary materials (Group 3: Cavit-W, Group 4: Systemp. inlay, Group 5: Cotton + Systemp. inlay, Group 6: Cotton + Cavit-W, Group 7: Teflon + Systemp. inlay and Group 8: Teflon + Cavit-W). The teeth were submitted to thermocycling, and a microleakage test was performed. Depth of dye penetration was measured. The collected data were statistically analyzed (α = 0.05).

RESULTS

Gp 7: Teflon + Systemp. inlay obtained the lowest infiltration values with no significant difference than (Gp 4: Systemp.inlay) and (Gp 8: Teflon + Cavit-W). Whereas (Gp 5: Cotton + Systemp.inlay) and (Gp 6: Cotton + Cavit-W) presented the highest significant microleakage values among other experimental groups.

CONCLUSION

Regarding temporization after endodontic treatment, Teflon combined with Systemp.inlay and Cavit-W presented the best temporary materials regarding microleakage control. At the same time, cotton combined with Cavit-W presented the worst temporary material for microleakage control. Cotton is not to be used in the temporization of endodontic-treated teeth.

CLINICAL IMPLICATION

Creating a tight seal in root canals that have undergone endodontic treatment is crucial for a successful, durable final restoration. Clinical and laboratory research results are an essential factor in determining how well endodontic materials seal.

Polytetrafluoroethylene for interim restoration of post spaces

Bacterial recontamination of the empty space is of concern in the time between the post space preparation and cementation of a cast post-and-core. This dental technique describes a novel treatment approach with sterilized polytetrafluoroethylene tape and a reinforced zinc-oxide eugenol restorative material to maintaining asepsis of the root canal space while awaiting fabrication and delivery of a cast post-and-core. On delivery of the cast post-and-core, the material can be removed with minimal time and effort.

Assessment of the effect of spacer material on gap and void formation in an endodontic temporary restoration using micro-computed tomography

This study aimed to evaluate the effect of two spacer materials (cotton pellet and polytetrafluoroethylene [PTFE]) on gap and void formation in the Cavit restoration used for endodontic temporization. Thirty-four extracted human single-rooted premolars were matched and allocated into two groups (n = 17/group) according to the access cavity spacer (cotton pellet or PTFE). Standardized endodontic access cavities were prepared in all the teeth. Subsequently, the teeth were scanned by micro-computed tomography (micro-CT) to determine the volume of the access cavities. The teeth were then temporized by placing either cotton pellet or PTFE as spacer materials on the canal orifices, followed by the Cavit restoration. Following the temporization procedure, the teeth were subjected to a second micro-CT scan to determine the percentage volume of gaps and voids along the margins and within the Cavit restoration, respectively. Statistical analysis was performed using the Shapiro-Wilk and Wilcoxon signed-rank tests with a 5% significance level. The PTFE spacer was associated with significantly less gap formation between the Cavit restoration and the access cavity walls (P < 0.05) compared with the cotton pellet. No difference existed in void formation between the groups (P > 0.05). These findings indicate that the spacer material placed under the Cavit restoration can influence the quality of overlying restoration. PTFE was associated with less gap formation and, therefore, performed better than the cotton pellet as a spacer material beneath the Cavit restoration during endodontic treatment.

Undergraduate Endodontic Training and Its Relation to Contemporary Practice: Multicenter Cross-Sectional Study in Saudi Arabia

Materials and Methods

An online questionnaire was developed and emailed to all dental schools in Saudi Arabia. This questionnaire was answered by the endodontic undergraduate program director. The data collected were analysed using descriptive statistics.

Results

The response rate was 96.15%, which means twenty-five out of twenty-six dental schools participated in the study. The majority of the academic supervisors was endodontists (92%). The use of magnification and ultrasonic tips was not required by 84% and 76% of the dental schools, respectively. The main endodontic treatment techniques were the step-back technique and gates glidden for cleaning and shaping (76%) and cold lateral compaction for obturation (92%).

Conclusions

The dental students were supervised by endodontic specialists and trained to use traditional endodontic methods. Encouraging dental educators to train students to use modern technology and equipment would probably improve their graduate clinical skills and performance.

Antimicrobial evaluation of polytetrafluoroethylene used as part of temporary restorations: An ex vivo study

The use of polytetrafluoroethylene (PTFE) tape as the base layer of temporary restorations had gained popularity mainly due to the ease of manipulation. The aim of this study was to assess whether this method changes the potential for bacterial growth and leakage of temporary restorations. The direct contact test and live/dead fluorescent staining were used for comparing Enterococcus faecalis growth and biofilm formation on PTFE, composite, intermediate restorative material (IRM) and Coltosol F. Confocal laser scanning microscopy was employed to evaluate E. faecalis penetration through 2 mm of PTFE, IRM or Coltosol F placed on the bottom of the pulp chamber and into radicular dentinal tubules in extracted maxillary third molars. The results demonstrated that E. faecalis grows on and penetrates through PTFE significantly more than it does with IRM and Coltosol F, revealing its comparably reduced overall antimicrobial sealing ability when placed as the base part of temporary restorations.

Common Temporization Techniques Practiced in Saudi Arabia and Stability of Temporary Restoration

Introduction

Coronal leakage is detrimental to the long-term success of root canal treatment (RCT). While much emphasis is being placed on the quality of the final restoration, little attention is given to the temporary restoration placed in between root canal treatment appointments. The aim of this study was to survey temporization techniques practiced in Saudi Arabia and the frequency of observing temporary material breakdown or complete loss.

Materials and Methods

An online questionnaire was distributed among general dentists, dental specialists, and clinical trainees in undergraduate and postgraduate dental programs. The sample size was estimated at 370 participants. Data were analyzed using descriptive statistics and chi-square tests.

Results

The total number of participants who met the inclusion criteria was 525. The majority of them (94.6%) were practicing two-visit RCT. The most common temporization materials were Cavit (50.3%) followed by glass ionomer cement (32%). The majority (72.6%) of participants claimed they allow a thickness of 2-3 mm for temporary restorations. Many participants (60.4%) used a spacer material during temporization, and the cotton pellet was the most common spacer material. Temporary restoration breakdown or complete loss was a common observation. Although the duration between the two RCT visits was 2 weeks or less for 83.6% of participants, only 19.6% of participants claimed that they rarely observed temporization breakdown.

Conclusion

Two-visit RCT is commonly practiced in Saudi Arabia, and endodontists performed significantly more single-visit procedures. Temporization practices may lack uniformity; however, clinicians were more likely to use calcium sulfate-derived material for two weeks or less. They allow for 2-3 mm thickness restoration and use a cotton pellet as a spacer. According to their clinical observation, temporary material breakdown or complete loss was frequent. This mandates further attention in research and education.

Microbial Contamination Comparison Between Cotton Pellet and Polytetrafluoroethylene Tape Endodontic Spacers: A Systematic Review

This systematic review compares polytetrafluoroethylene tape and cotton pellet when used as endodontic spacers underneath provisional restorations. The review followed the PRISMA guidelines and was registered in the PROSPERO database (CRD42020176555). Studies that compared the microbial contamination between polytetrafluoroethylene tape and cotton pellet, when used as spacers, were included. Literature searches of Pubmed, Embase, EBSCOHost Dentistry & Oral Sciences Source, Scopus, and Open Grey databases were conducted from their inception until May 2020 for studies in English or other Latin script languages. Hand searching of reference lists was performed. Three laboratory and three clinical studies were included. The risk of bias of the component studies varied widely. Results from the laboratory studies showed higher bacterial counts for cotton pellets. Results from the clinical studies showed that polytetrafluoroethylene tape was associated with a significantly lower incidence of microbial contamination. Findings were consistent throughout the studies, though the evidence available is scarce and heterogeneous. Polytetrafluoroethylene tape was associated with less microbial contamination when compared with cotton pellets as endodontic spacers and therefore appears to be a more suitable material for the purpose.