Effect of Ultrasonic Irrigation Combined with Epoxy Resin Paste in Single Visit Root Canal Treatment in Chronic Pulpitis.

OBJECTIVE: To determine the clinical efficacy of ultrasonic irrigation combined with epoxy resin-based sealer in single visit root canal treatment of chronic pulpitis. STUDY DESIGN: Randomised controlled trial. Place and Duration of the Study: Department of Stomatology, Hefei BOE Hospital, Hefei, China, from March 2019 to December 2021. METHODOLOGY: Ninety patients with chronic pulpitis, comprising 104 affected teeth, were enrolled. Using a random number table, they were divided into Group A (n = 30, 35 teeth), Group B (n = 30, 35 teeth), and the control group (n = 30, 34 teeth). All underwent single visit root canal treatment. Group A received ultrasonic irrigation followed by sealing with epoxy resin-based paste; Group B had conventional syringe irrigation followed by the same sealing; the control group had syringe irrigation and closure with zinc oxide-eugenol paste. Pain during treatment, posttreatment clinical outcomes, and differences in inflammatory markers (IL-4, IL-6, hs-CRP), and quality of life (QOL) scores pre- and posttreatment over two months were observed. RESULTS: After the treatment, improvement rates for Groups A, B, and the control group were 91.4%, 65.7%, and 61.7%, respectively. Pain occurrence rates were 6.7%, 30.0%, and 36.7%, respectively. Group A outperformed both Group B and the control group in improvement and pain incidence with statistical significance (p<0.016). Posttreatment, Group A had lower IL-4, IL-6, hs-CRP levels than Groups B and the control group (p<0.05), and had higher scores for sleep, mood, and appetite (p<0.05). CONCLUSION: Ultrasonic irrigation combined with epoxy resin-based paste yields better results for chronic pulpitis treatment, reducing postoperative pain, mitigating inflammation levels, and enhancing quality of life. KEY WORDS: Chronic pulpitis, Ultrasonic irrigation, Epoxy resin paste, Root canal treatment, Therapeutic effect.

Microfiltración apical entre dos cementos de obturación: biocerámico y resinoso en premolares unirradiculares preparadas con protaper, y obturadas con condensación lateral / Apical microfiltration between two filling cements: bioceramic and resinous in unirradicular premolars prepared with protaper and sealed with lateral condensation

Resumen Objetivo: Comparar in vitro la microfiltración apical en premolares unirradiculares obturados con cemento a base de resina epóxica y cemento biocerámico. Método: 40 piezas dentales unirradiculares fueron seleccionadas y divididas en dos grupos para ser obturadas esperando el tiempo de fraguado de acuerdo con las instrucciones del fabricante. El grupo A se obturó con cemento biocerámico Endosequence y, el grupo B, con cemento a base de resina epóxica AH-Plus: posteriormente los dos grupos fueron sellados con barniz de uñas hasta 3mm de la parte apical, luego se colocaron las muestras en la incubadora a 37ºC. Ambos fueron sometidos a 750 ciclos de termociclado, para reproducir el ambiente parecido a la cavidad oral. Para análisis de microfiltración se utilizó el método de difusión del colorante, se sumergieron en azul de metileno al 2 % por 6 días, posteriormente los especímenes fueron sometidos en una bomba de vacío. Los dientes fueron cortados longitudinalmente para ser evaluadas mediante el estereomicroscopio. El análisis estadístico fue hecho mediante T-Student y Chi-Cuadrado. Resultados: El grupo A corresponde a Endosequence obtuvo una medida de 0,55mm y el grupo B corresponde a AH-Plus 1,20mm con un estimado de significancia de p=0,013. Conclusión: El análisis de ambos cementos de obturación demostró que Endosequence posee menor microfiltración apical que AH-Plus.

Abstract Aim: To compare in vitro by the stereomiscroscope the lesser apical microfiltration in uniradicular premolars, between the cement based on Epoxy Resin and Bioceramic cement. Method: The study was performed on 40 uniradicular dental pieces divided into two groups, the samples were prepared using the protaper system and the obturation was performed using the lateral condensation technique, the first group was sealed withEndosequence bioceramic cement and the second group with Cement based on AH-Plus epoxy resin, then sealed with nail varnish up to 3mm from the apical part, then the samples were placed in the incubator at 37ºC, waiting for the set time corresponding to each group according to the manufacturer's instructions . The two groups of the present study were submitted to 750 cycles of thermocycling, to provide an environment similar to the oral cavity, then longitudinal cuts were made to the samples. The microfiltration was evaluated using the dye diffusion method, immersed in 2% methylene blue for 6 days, then the specimens were subjected to a vacuum pump. The teeth were cut longitudinally to be evaluated by the stereomicroscope. The statistical analysis was through T-Student and Chi-Square. Results: Group A corresponds to Endosequence obtained a mean of 0,55mm and Group B corresponds to AH-Plus 1,20mm with an estimated significance of p = 0,013. Conclusion: Both obturation cements have significant differences, therefore Endosequence has less apical microfiltration than AHPlus.

Dissolution, dislocation and dimensional changes of endodontic sealers after a solubility challenge: a micro-CT approach.

AIM: To evaluate, using a novel micro-CT approach, the solubility and dimensional changes of an MTA-based sealer inside the root canal system after a solubility challenge. The MTA-based material (MTA Fillapex) was compared to a gold standard epoxy-based endodontic sealer (AH Plus). METHODOLOGY: Ten human mandibular premolars with a single canal were divided randomly into two groups (n = 5) according to the sealer used. The canals were instrumented using the Reciproc System (VDW) with a R40 file and filled with R40 gutta-percha cones and one of the sealers. The filled canals were immediately scanned in a micro-CT, and after that, the teeth were immersed in 20 mL phosphate-buffered saline (PBS) at 37 °C for 7 days, when they were removed and rescanned. Final image stacks were registered against the initial stacks and the numerical difference between the initial and final volume of the filling material was obtained. Calculations were performed to identify dimensional changes of the filling material. All image stacks were 3D rendered to disclose areas of dislocation of the filling material inside or outside the root canal. The Shapiro-Wilk's test revealed that data were normally distributed; thus, the Student's t-test was used to detect statistically significant changes, assuming a 5% α-error. RESULTS: No significant changes were seen for the percentage volume of material lost after the solubility challenge for both AH Plus and MTA Fillapex groups (1.44% and 1.16%, respectively). A significant difference was, however, found for the volume of filling material which revealed dimensional changes after the solubility test (6.68% for MTA Fillapex and 1.09% for AH Plus). In fact, observation of 3D models disclosed that MTA Fillapex was associated with material extrusion through the foramen in all but one sample. In AH Plus filled samples, no material extrusion was detected. CONCLUSIONS: Although the solubility of both sealers was similar using this novel micro-CT approach, MTA Fillapex was associated with significant dimensional changes related to material extrusion through the apex after PBS storage compared to AH Plus.

Effectiveness of different final irrigation techniques and placement of endodontic sealer into dentinal tubules

Abstract: The aim of this study was to compare two irrigation techniques and four devices for endodontic sealer placement into the dentinal tubules. Ninety-nine single-rooted human teeth were instrumented and allocated to either the control (CO) (n=11) or experimental groups according to the irrigation method: syringe and NaveTip needle (NT) (n=44), and EndoActivator (EA) (n=44). These groups were subdivided according to sealer placement into K-File (KF), lentulo spiral (LS), Easy Clean (EC), and EndoActivator (EA) subgroups. Moreover, the distances of 5 mm and 2 mm from the apex were analyzed. The teeth were obturated with AH Plus and GuttaCore X3. Analyses were performed by scanning electron microscopy associated to cathodoluminescence. The percentage and maximum depth of sealer penetration were measured. Data were evaluated by three-way analysis of variance (ANOVA) and Games-Howell test (p<0.05). EA was superior to NT in percentage of sealer penetration. EC was significantly superior to EA (subgroup) for sealer penetration, and both improved the percentage of sealer penetration when compared to LS. Better sealer penetration was observed at the distance of 5 mm from the apex. Sealer penetration into the dentinal tubules was significantly improved by sonic irrigant activation.

Effect of irrigation with Tetraclean on bacterial leakage of obturated root canals.

The purpose of the study presented here was to evaluate the effect of Tetraclean, Hypoclean, Chlor-XTRA, 2% chlorhexidine and 6% sodium hypochlorite/17% EDTA as a final irrigant on bacterial leakage of the root canal. One hundred and fifty-five extracted human maxillary central incisors were randomly divided into five experimental groups of 25 teeth each and two control groups of 15 teeth each. The root canals in each group were irrigated with 2 ml of the relevant irrigant between each filing. The root canals in group 5 were irrigated with 5 ml of 17% EDTA at the end of root canal preparation. The teeth in each group were obturated with gutta-percha and AH-26 sealer. Positive control teeth were obturated with a single gutta-percha cone without sealer, and negative controls were obturated in the same way as experimental groups. The coronal portion of each root was placed in contact with inoculum of Enterococcus faecalis in Brain Heart Infusion (BHI) culture media. Findings showed that the mean number of days for bacterial penetration in the Tetraclean group was greater than for other experimental groups. On the other hand, the Chlor-XTRA Vista group showed the fewest mean number of days for bacterial leakage.

Comparison of single cone obturation performance of different novel nickel-titanium rotary systems.

OBJECTIVES: The purpose of this study was to compare several different single-cone obturations in the gutta-percha-filled areas (PGFA), sealer-filled areas (PSFA) and voids, also determining the volumetric characteristics of the tested cones. MATERIALS AND METHODS: Curved mesial roots of 120 mandibular molars were instrumented using several different systems (ProTaper Next, Twisted File Adaptive, OneShape, ProTaper Universal, WaveOne and Reciproc) and filled with corresponding single cones. The teeth were then sectioned horizontally at 2, 4, 6 and 8 mm from the apex. The area values of each section were calculated and converted to percentages (PGFA, PSFA and voids) of the total area. To determine volumetric characteristics of the tested cones, 20 gutta-percha points of each tested group were scanned with CBCT using the same parameters. RESULTS: The ProTaper Next and WaveOne groups presented the most PGFA and least PSFA. The Twisted File Adaptive group presented the least PGFA and most PSFA (p < 0.05) and the least gutta-percha volume. CONCLUSIONS: The Twisted File Adaptive system matched cones had the least volume and the least PGFA in severely curved mesiobuccal canals of mandibular first molars. Single matched cones volume varied.

Apical Barrier Formation After Incomplete Orthograde MTA Apical Plug Placement in Teeth with Open Apex - Report of Two Cases

Two cases are reported in which incomplete placement of 4 mm mineral trioxide aggregate (MTA) plug was performed unintentionally at the apical third of permanent immature teeth with open apex and apical periodontitis. As confirmed radiographically, there were gaps between MTA and dentinal walls along the MTA-dentin interface. After setting of MTA was confirmed, endodontic treatment was completed and access was sealed with composite resin. At 6 to 16 months follow-up examinations, formation of dentin in contact with the MTA surface, as well as apical closure and periapical healing were ideied radiographically for both cases. The results of these cases showed that apical barrier formation and complete periapical healing is possible despite the incomplete apical placement of the MTA plug. This might be due to the biological properties of the MTA. Even so, an incomplete three-dimensional placement of the filling material is not advocated.

A quantitative and qualitative analysis of ultrasonic versus sonic endodontic systems on canal cleanliness and obturation.

OBJECTIVE: The purpose of this study was to compare 2 irrigation techniques by evaluating canal cleanliness and obturation of lateral/accessory canals. STUDY DESIGN: Seventy-five extracted canines were instrumented to a size #40/0.06 taper. The EndoActivator (EA) was compared with an ultrasonic unit for final irrigation. Each unit was used for 1 minute each with 6.15% NaOCl and 17% EDTA. A control group received syringe irrigation. Thirty teeth were sectioned and evaluated for debris removal and open dentinal tubules at 3/5 mm from the apical foramen with a scanning electron microscope. Forty-five teeth were examined for obturation of lateral canals. RESULTS: The EA was significantly better in removing debris at all levels when compared with other treatment groups (P < .05) and resulted in obturation of significantly more numbers of lateral canals (P < .01.) CONCLUSIONS: The EA provided better obturation of lateral and accessory canals and resulted in less remaining debris.

Effect of the angle of apical resection on apical leakage, measured with a computerized fluid filtration device.

OBJECTIVE: We determined the effect of the angle of apical resection on apical leakage using a computerized fluid filtration meter with a laser system and a digital air pressure regulator in 46 extracted single-rooted human teeth. Orthograde endodontic treatment was performed. The root canals were prepared up to a size 50 K-type file with 17% EDTA solution (Roth International, Chicago, IL) and 5% NaOCl solution as the irrigant. Gates Glidden burs (Maillefer Instruments, Ballaigues, Switzerland) were used to flare the coronal two thirds of the canal. All canals were dried with paper points and then obturated using cold lateral condensation (except for the positive controls) of gutta-percha points and AH plus (Dentsply DeTrey, Konstanz, Germany). All 40 roots were sectioned 3 mm from the apex. Forty teeth were assigned randomly into 1 of 4 experimental groups of 10 teeth each: in group 1, the teeth were resected apically (90° angle) and the cavities were obturated with mineral trioxide aggregate (MTA); in group 2, after apical resection (90° angle), a root-end cavity was prepared using ultrasonic diamond retrotips and the cavities were obturated with MTA; in group 3, the teeth were resected apically (∼45° angle) and the cavities were obturated with MTA; and in group 4, after apical resection (∼45° angle), a root-end cavity was prepared using ultrasonic diamond retrotips and the cavities were obturated with MTA. An additional 6 teeth were used as controls (3 each, negative and positive controls). Apical leakage was measured using a computerized fluid filtration meter with a laser system. RESULTS: The mean apical microleakage was 2.0 ± 0.4 × 10(-4), 1.6 ± 0.6 × 10(-4), 1.6 ± 0.9 × 10(-4), and 1.8 ± 0.7 × 10(-4) µL/cmH(2)O/min(-1) at 1.2 atm, in groups 1 to 4, respectively. Although the mean apical microleakage was greater in group 1, the differences among the 4 groups were not statistically significant (P > .05). CONCLUSIONS: The results of these in vitro studies showed that when an adequate retrograde cavity depth is prepared, variation in the root-end cutting angle does not necessarily cause any difference in microleakage.

Nd:YAG laser irradiation effect on apical intracanal dentin - a microleakage and SEM evaluation

The purpose of this in vitro study was to evaluate the effect of neodymium:yttrium-aluminum-garnet (Nd:YAG) laser irradiation on intracanal dentin surface by SEM analysis and its interference in the apical seal of filled canals. After endodontic treatment procedures, 34 maxillary human incisors were randomly assigned to 2 groups. In the negative control group (n=17), no additional treatment was performed and teeth were filled with vertically condensed gutta-percha; in the laser-treated group (n=17), the root canals were irradiated with Nd:YAG laser (1.5 W, 100 mJ, 15 Hz) before filling as described for the control group. Two specimens of each group were prepared for SEM analysis to evaluate the presence and extent of morphological changes and removal of debris; the other specimens were immersed in 0.5 percent methylene blue dye (pH 7.2) for 24 h for evaluation of the linear dye leakage at the apical third. SEM analysis of the laser-treated group showed dentin fusion and resolidification without smear layer or debris. The Student’s t-test showed that the laser-treated group had significantly less leakage in apical third than the control group. Within the limitations of this study, it may be concluded that the morphological changes on the apical intraradicular dentin surface caused by Nd:YAG laser resulted in less linear dye apical leakage.

Apical microleakage and SEM analysis of dentin surface after 980 nm diode laser irradiation

This study evaluated the effect of 980-nm diode laser on apical microleakage and intraradicular dentin morphology. Roots of 110 mandibular incisors were used in the study: 92 for microleakage test and 18 for scanning electron microscopy (SEM). Roots were randomly assigned to 3 groups according to the irrigating solution (water, NaOCl and NaOCl/EDTA) and were divided into 3 subgroups according to the laser irradiation protocol (without irradiation, irradiated at 1.5 W and irradiated at 3.0 W). Two specimens of each subgroup were prepared for SEM. The remaining roots were filled with AH Plus and gutta-percha. Apical leakage was assessed by ink penetration and data were analyzed statistically by ANOVA and Tukey-Krammer test (α=0.05). SEM analysis showed intensification of changes with increase of laser power as well as variations according to the irrigating solution. Modified smear layer was observed in specimens treated with water and irradiated with laser. Roots irrigated with NaOCl/EDTA had lower levels of infiltration (0.17 ± 0.18 mm) differing significantly (p<0.05) from those of roots irrigated with water (0.34 ± 0.30 mm), but similar (p>0.05) to those irrigated with NaOCl (0.28 ± 0.29 mm). Non-irradiated roots had lower levels of infiltration (0.10 ± 0.14 mm), differing (p<0.05) from those irradiated at 1.5 W (0.32 ± 0.22 mm) and 3.0 W (0.37 ± 0.32 mm). The 980 nm diode laser modified dentin morphology and increased apical microleakage.

Este estudo avaliou o efeito do laser de diodo 980 nm na microinfiltração apical e na morfologia intrarradicular da dentina. Raízes de 110 incisivos inferiores foram utilizadas no estudo: 92 para o teste de microinfiltração e 18 para microscopia eletrônica de varredura (MEV). As raízes foram divididas em 3 grupos de acordo com a solução irrigante (água, NaOCl e NaOCl/EDTA) e subdivididas em 3 de acordo com a irradiação laser (sem irradiação, irradiados com 1,5 W e irradiados com 3,0 W). Duas amostras de cada subgrupo foram preparadas para MEV. As raízes restantes foram preenchidas com AH Plus e guta percha. A infiltração apical foi avaliada nas raízes por meio da penetração do corante e os dados foram analisados por ANOVA e teste de Tukey-Krammer (α=0,05). Os resultados da MEV mostraram intensificação das mudanças quando se aumentou a potência do laser e variações de acordo com a solução irrigadora. Camada de smear modificada foi observada em espécimes tratados com água e irradiados com laser. Raízes irrigadas com NaOCl/EDTA tiveram níveis menores de infiltração (0,17 ± 0,18 mm) estatisticamente diferente (p<0,05) das raízes irrigadas com água (0,34 ± 0,30 mm), mas semelhante (p>0,05) aos irrigados com NaOCl (0,28 ± 0,29 mm). As raízes não irradiadas tiveram níveis menores de infiltração (0,10 ± 0,14 mm), diferente (p<0,05) de 1,5 W (0,32 ± 0,22 mm) e 3.0 W (0,37 ± 0,32 mm). O laser de diodo 980 nm alterou a morfologia da dentina e aumentou a infiltração marginal apical.

Effect of Er,Cr:YSGG laser irradiation on the apical sealing ability of AH Plus/gutta-percha and Hybrid Root Seal/Resilon Combinations.

OBJECTIVE: The objective of this study was to evaluate the sealing ability of 2 different resin-based endodontic filling systems after smear layer removal with 2 different techniques. STUDY DESIGN: Extracted human single-rooted teeth (n = 74) were instrumented using HERO Shaper rotary instruments and irrigated with 1 mL of 2.5% NaOCl between each instrument. Additionally, the canals received either an extra 3-minute rinse with 2 mL of 17% EDTA or a 40-second Er,Cr:YSGG laser treatment. The root canals were filled with either Hybrid Root Seal/Resilon combination or AH Plus/gutta-percha combination using lateral condensation technique (n = 11). Apical leakage quantity was measured with the computerized fluid filtration meter at 1 and 4 weeks. One root from each group, which was not submitted to the fluid filtration test, was selected for scanning electron microscopy (SEM) analysis. Statistical analysis was performed using 3-way ANOVA and the post hoc Tukey HSD test (α = 0.05). RESULTS: A significant decrease was observed in the microleakage values of all the experimental groups tested with time (P < .0001). EDTA + AH Plus/gutta-percha combination exhibited the least microleakage, whereas laser irradiation + Hybrid Root Seal/Resilon combination showed the greatest microleakage at each of the 2 time periods. Each experimental combination exhibited architecture in SEM that seemed to correlate with its sealing performance. CONCLUSION: Er,Cr:YSGG laser treatment does not enhance the sealing ability of the sealers compared with EDTA application. The root canal adaptation and sealing ability of the Hybrid Root Seal/Resilon combination is not superior to that of the AH Plus/gutta-percha combination.

Marginal adaptation and cytotoxicity of bone cement compared with amalgam and mineral trioxide aggregate as root-end filling materials.

INTRODUCTION: Bone cements have a well-established place in the practice of orthopedic surgery. It has many characteristics that make it well-suited as a root-end filling material. The purpose of this study was to evaluate the marginal adaptation and cytotoxic effect of polymethylmethacrylate (PMMA) bone cement, mineral trioxide aggregate (MTA), and amalgam as root-end filling materials. METHODS: Thirty extracted human single-rooted teeth were cleaned, shaped, and obturated with gutta-percha and AH 26 sealer. The roots tips were removed; root-end cavities were prepared and filled with the 3 tested materials (bone cement, MTA, and amalgam). Impressions of retrofilled root ends were taken by polysiloxane impression material, and positive replicas were fabricated by using epoxy resin. The original roots were longitudinally sectioned into 2 halves; both the replicas and longitudinal sections were prepared for scanning electron microscope to measure the gaps at the material/dentin interface. Human periodontal ligament fibroblast tissue culture was used to assess the cytotoxicity of the 3 tested materials. RESULTS: The obtained data revealed that both bone cement and MTA exhibited a better adaptation to the dentinal walls than that of amalgam. Also, the cytotoxicity testing showed that bone cement had a comparable cytotoxic effect on fibroblast cells with MTA; both root-end filling materials showed less cytotoxicity than that of amalgam. CONCLUSIONS: PMMA bone cement could be considered as a promising root-end filling material.

Comparison of the sealing ability of three filling techniques in canals shaped with two different rotary systems: a bacterial leakage study.

OBJECTIVE: This study compared the sealing ability of 3 current filling techniques in root canals shaped with 2 different rotary systems. STUDY DESIGN: Eighty human extracted mandibular premolars were divided randomly into 2 similar groups of 40 each and instrumented with either ProTaper (Dentsply Maillefer, Tulsa, OK; group A) or Mtwo (VDW; Antaeos, Munich, Germany; group B) rotary systems. Each group was divided into 3 subgroups (n = 10) and 2 control groups (n = 5). Canals were filled either with the tapered single-cone technique (SC; subgroups A1 and B1), with lateral condensation (LC; subgroups A2 and B2), or warm vertical compaction (WVC; subgroups A3 and B3). AH Plus was used as a root canal sealer in all groups. Samples were sterilized in an ethylene oxide sterilizer for 12 hours. The apical 3-4 mm of the roots were immersed in brain-heart infusion culture medium with phenol red indicator within culture chambers. The coronal access of each specimen was inoculated every 48 hours with a suspension of Enterococcus faecalis. Bacterial leakage was monitored every 24 hours for 8 weeks. The data obtained were analyzed using a chi-squared test, and P was set at .05. RESULTS: In group A, 70% of the specimens filled with SC (subgroup A1), 50% of the specimens filled with LC (subgroup A2), and 20% of the specimens filled with WVC (subgroup A3) leaked. There was no statistically significant difference between the subgroups (P > .05). In group B, bacterial leakage was observed in 50% of SC samples (subgroup B1), 40% of LC samples (subgroup B2), and 50% of WVC samples (subgroup B3). There was no statistically significant difference between subgroups B1, B2, and B3 (P > .05). There was also no statistically significant difference between group A and group B (P > .05). CONCLUSION: Filling with SC, LC, and WVC techniques in canals treated with ProTaper or Mtwo rotary instruments showed similar levels of sealing efficacy.

The evaluation of the influence of using MTA in teeth with post indication on the apical sealing ability.

OBJECTIVES: The aim of this study was to evaluate the influence of using MTA in teeth with post-core indication and to compare it with the immediate or delayed post space preparation on the integrity of apical seal in teeth filled with gutta-percha and sealer. STUDY DESIGN: Fifty-one single-rooted freshly extracted human maxillary incisor teeth were selected. The crowns of the teeth were removed to a length of 14 mm and canals were prepared by using K-files with the step-back technique. The teeth were randomly divided into 3 groups of 15 specimens each. Group A was filled with gutta-percha and sealer using lateral compaction, and post space was prepared immediately using a heated instrument. Specimens in Group B were filled with the same materials as Group A and post space was prepared after 1 week with Gates-Glidden drills. Group C was filled with MTA as an apical 5-mm filling. In all groups, materials were left in the root canals at the apical 5-mm level. The remaining 6 teeth were used as controls. The microleakage values of each group were measured after 1 month, using a computerized fluid filtration method. RESULTS: The MTA (Group C) showed less microleakage than immediate and delayed post space preparation methods (Group A, B) in 1 month, and this difference was found to be statistically significant (P < .005). Additionally, no statistically significant difference was determined between Group A and Group B (P > .05). CONCLUSION: These results suggest that MTA can be used in the root canals as apical filling material in teeth with post-core indication.

An in vitro evaluation of the apical sealing ability of new polymeric endodontic filling systems.

OBJECTIVE: The objective of this study was to compare the short-term sealing abilities of recently introduced polymeric endodontic filling systems. STUDY DESIGN: Root canals of 120 extracted and decoronated human single-rooted teeth were instrumented using crown-down technique with HERO Shaper rotary instruments. The roots were divided randomly into 8 groups (6 experimental and 2 control groups of 15 roots each) and filled with different combinations of core and sealer as follows: group 1, RealSeal/Resilon; group 2, RealSeal/Herofill; group 3, Hybrid Root Seal/Resilon; group 4, Hybrid Root Seal/Herofill; group 5, MM-Seal/Resilon; group 6, MM-Seal/Herofill; group 7, positive controls (Herofill only); group 8, negative controls. Apical leakage quantity was evaluated after 1 week by using a fluid filtration model. For each sample, measurements of fluid movement were recorded at 2-minute intervals for a total of 8 minutes, and then averaged. The data were calculated and analyzed using the Kolmogorov-Smirnov test, 1-way analysis of variance (ANOVA), and the Tukey test. Significance was set at P less than .05. RESULTS: Multiple paired comparisons (Tukey test) showed that, of all the groups, MM-Seal/Herofill combination exhibited the least microleakage, and RealSeal/Herofill combination ranked second in this regard. The mean leakage values for the RealSeal/Resilon and MM-Seal/Resilon combinations were both significantly higher than the means for the other 4 experimental groups (P < .01). Hybrid Root Seal combined with Resilon resulted in significantly less microleakage than Hybrid Root Seal combined with Herofill (P = .001). CONCLUSION: The results suggest that the sealing properties of epoxy-resin-based sealer (MM-Seal) combined with gutta-percha (Herofill) are superior to those of methacrylate-based sealers (Hybrid Root Seal and Realseal) combined with Resilon.

Evaluation of ultrasonic and ErCr:YSGG laser retrograde cavity preparation.

Root end cavity preparation techniques aim to create a clean and properly shaped cavity in a short time. Although the use of ultrasonics has been widely recommended, a laser can also be used. This study evaluated the time required and quality of retrograde cavity preparations using ultrasonics or ErCr:YSGG laser. Thirty single-rooted teeth were instrumented, root filled, submitted to apicectomies, and grouped. Root end cavities were prepared by using the following: group 1 (G1): CVD (6.1107-6) ultrasonic retrotips (CVD-Vale, São José dos Campos, Brazil); group 2 (G2): EMS (DT-060/Berutti) ultrasonic retrotips (EMS, LeSentier, Switzerland); and group 3 (G3): ErCr:YSGG (G6/Waterlase; Biolase Technology, San Clemente, CA) laser tips. The time taken to complete the preparation was recorded. Epoxy resin replicas of the root apices were examined under a scanning electron microscope. The parameters for evaluation were the presence of fractures, and the quality of the preparations. The Waterlase showed the highest mean time for preparation of the root end cavities (p < 0.05), and there was no significant difference between the CVD and EMS groups (p > 0.05). Fractures in the cavosurface angle occurred only in G2. G1 and G2 showed better scores for quality of preparation than G3 (p < 0.05). These results suggest that root end cavities should be prepared by ultrasonic tips.

Assessment of a new root canal sealer's apical sealing ability.

OBJECTIVE: The aim of this study was to investigate the apical sealing ability of a newly introduced root canal sealer: iRoot SP Root Canal Sealer. STUDY DESIGN: Sixty-eight extracted human anterior single-root teeth were used. The coronal part of each tooth was removed and the root canals were prepared with ProTaper files. The specimens were divided into 3 groups of 20 teeth each. Group A specimens were filled with iRoot SP using the continuous wave condensation technique; Group B specimens were obturated with iRoot SP using a single cone technique; Group C specimens were filled with AH plus by means of the continuous wave condensation technique. Evaluation of the apical leakage was performed with a fluid filtration method at 24 hours and 1, 4, and 8 weeks. Scanning electron microscopy (SEM) was used to qualitatively assess what mechanisms might be responsible for leakage of the different groups. RESULTS: There was no significant difference in fluid leakage among the groups, as well as no time effect on leakage (P > .05). SEM revealed both gap-free regions and gap-containing regions in canals filled with both materials. CONCLUSION: iRoot SP was equivalent to AH Plus sealer in apical sealing ability.

Microleakage evaluation of roots filled with different obturation techniques and sealers.

OBJECTIVE: The aim of this study was to compare the apical seal of the Single-cone ProTaper gutta-percha technique and the lateral compaction technique in combination with 3 sealers (AH-26, Apexit, and Sealite-Ultra). STUDY DESIGN: Seventy extracted single-root teeth were used. Root canals were prepared with ProTaper rotary instruments. Six groups were formed: (I) Single-cone ProTaper gutta-percha with AH-26; (II) lateral compaction technique with AH-26; (III) Single-cone ProTaper gutta-percha with Apexit; (IV) lateral compaction technique with Apexit; (V) Single-cone ProTaper gutta-percha with Sealite-Ultra; and (VI) lateral compaction technique with Sealite-Ultra. The fluid conductance of each specimen was measured after the 7th and 30th days using a fluid filtration method. RESULTS: When lateral compaction was performed, all sealers showed similar levels of leakage (P > .05). Using the single-cone technique, Sealite-Ultra showed more leakage than the others (P < .05). Comparing filling techniques, there was a significant difference only in the Sealite-Ultra groups (P < .05). CONCLUSION: Single-cone ProTaper gutta-percha and lateral compaction techniques showed similar sealing effect.

Comparison of apical and coronal sealing in canals having tapered cones prepared with a rotary NiTi system and stainless steel instruments.

The purpose of this study was to compare the sealing ability of different tapered gutta percha cones that were used with lateral compaction and single cones in canals prepared with various root canal instruments. One hundred extracted maxillary incisor roots were used. In group 1, 30 roots were prepared with stainless steel instruments (SS) and then filled by the lateral compaction technique using .02 tapered master cones. In group 2, 30 roots were prepared with ProFile nickel titanium instruments (NiTi) and filled in the same way as group 1. In group 3, 30 roots were filled by the single cone technique using 0.06 tapered gutta-percha cones. The remaining 10 teeth were taken as two control groups. Apical and coronal leakage was evaluated using the fluid filtration model. Considering the effects of the instrumentation, no statistically significant differences were found between the groups prepared with SS and NiTi (P > 0.05). When the effects of obturation technique were taken into consideration, the ProFile instruments and lateral compaction resulted in significantly less coronal leakage than the SS instruments and lateral compaction (P < 0.05). There were no significant differences in apical leakage among any of the groups (P > 0.05).