Influence of sealer and supplementary approach on filling material removal during endodontic retreatment.

Both root canal sealer-based and supplementary protocols may influence removal of filling material during endodontic retreatment. Mesial root canals of extracted mandibular molars were prepared using HyFlex EDM 25/.08, and filled with a calcium silicate sealer (Bio-C Sealer), or an epoxy resin (AH Plus), using the single cone technique (n = 12). Retreatment was performed using ProDesign Logic (PDL) RT and PDL 35/.05. The specimens were randomly divided into two experimental groups (n = 12), and the sealers were distributed similarly. A supplementary protocol was performed with PDL 50/.01 or XP-endo Finisher. Root canal transportation and volume, in addition to the remaining filling material percentage were evaluated using high-resolution (5 µm voxel size) micro-CT. Statistical analysis was performed using t-tests (α = 0.05). Root canals filled with AH Plus presented high residual filling material (p < 0.05). Both protocols decreased residual volume of filling material in the apical third (p < 0.05). PDL 50/.01 increased the apical root canal volume (p < 0.05). No difference was observed between the systems regarding canal transportation (p > 0.05). In conclusion, AH Plus is more difficult to remove from the apical third than Bio-C Sealer. PDL 50/.01 and XP-endo Finisher enabled greater removal of filling materials in the apical third, in the retreatment of curved root canals, without promoting apical transport.

Filling ability of ready-to-use or powder-liquid calcium silicate-based sealers after ultrasonic agitation.

This study evaluated the effect of ultrasonic agitation on the filling capacity of ready-to-use calcium silicate-based sealer Bio-C Sealer (BCS, Angelus, Paraná, Brazil) or powder-liquid BioRoot RCS (BR, Septodont, Saint-Maur-des-Fossés, France) using curved artificial canals by micro-computed tomography (micro-CT). Additionally, flow (mm) and flow area (mm2) were evaluated for both materials. Acrylic resin main canal (60° curvature and 5 mm radius, with 3 lateral canals in the cervical, middle, and apical thirds) were prepared up to size 40/.05 (Prodesign Logic, Brazil). The agitation method was used with ultrasonic tip (US, Irrisonic, Helse, Brazil): BCS, BCS/US, BR, and BR/US. All specimens were filled using the single-cone technique. The samples were scanned by micro-CT (8,74 µm) after obturation. The percentage of filling material and voids were calculated. Flow was evaluated based on ISO 6876/2012 standards (mm) and area (mm2). The data were statistically analyzed using ANOVA and Tukey tests (α = 0.05). BR/US showed lower percentage of filling material in the lateral canals than and, BCS/US (p<0.05). BR/US resulted in a higher percentage of voids than BR in the lateral apical third (p<0.05). BCS showed higher flow than BR (p<0.05). BCS and BR presented proper filling capacity in the simulated curved canals regardless of the use of ultrasonic agitation. However, BR/US showed more voids in the apical third. BCS demonstrates higher filling ability.

Flatsonic Ultrasonic Tip Optimizes the Removal of Remaining Filling Material in Flattened Root Canals: A Micro-computed Tomographic Analysis.

INTRODUCTION: The aim of this study was to evaluate the effectiveness of the XP-endo Finisher R (XPFR; FKG Dentaire, La Chaux-de-Fonds, Switzerland) or the Flatsonic ultrasonic tip (Helse Ultrasonic, Santa Rosa de Viterbo, SP, Brazil) in removing remaining filling material after the retreatment of flattened root canals using micro-computed tomographic imaging. METHODS: Twenty-four flattened distal root canals of mandibular molars with a buccolingual diameter 4 or more times larger than the mesiodistal diameter were prepared with Reciproc Blue (RB) R40 (VDW GmbH, Munich, Germany) and filled using the Tagger hybrid technique. All canals were retreated with RB R40, and apical enlargement was performed with RB R50 (VDW GmbH). The specimens were randomly distributed into 2 groups: XPFR or Flatsonic (n = 12). The percentage of remaining filling material after retreatment and centralization ability was evaluated. Data were submitted to Mann-Whitney, Wilcoxon, and unpaired t tests (α = 5%). RESULTS: Greater capacity to remove remaining filling material in the entire canal and the cervical and middle thirds was observed for the Flatsonic compared with the XPFR (P < .05). However, both supplementary cleaning techniques showed a similar percentage of residual filling material in the apical third (P > .05). No difference was observed in the centralization ability between the techniques (P > .05). CONCLUSIONS: The Flatsonic promotes greater removal of remaining filling material than the XPFR in the retreatment of flattened root canals. However, both supplementary cleaning approaches were similar in the apical third. The XPFR and Flatsonic were able to maintain root canal centralization.

Filling ability of ready-to-use or powder-liquid calcium silicate-based sealers after ultrasonic agitation

Abstract This study evaluated the effect of ultrasonic agitation on the filling capacity of ready-to-use calcium silicate-based sealer Bio-C Sealer (BCS, Angelus, Paraná, Brazil) or powder-liquid BioRoot RCS (BR, Septodont, Saint-Maur-des-Fossés, France) using curved artificial canals by micro-computed tomography (micro-CT). Additionally, flow (mm) and flow area (mm2) were evaluated for both materials. Acrylic resin main canal (60° curvature and 5 mm radius, with 3 lateral canals in the cervical, middle, and apical thirds) were prepared up to size 40/.05 (Prodesign Logic, Brazil). The agitation method was used with ultrasonic tip (US, Irrisonic, Helse, Brazil): BCS, BCS/US, BR, and BR/US. All specimens were filled using the single-cone technique. The samples were scanned by micro-CT (8,74 µm) after obturation. The percentage of filling material and voids were calculated. Flow was evaluated based on ISO 6876/2012 standards (mm) and area (mm2). The data were statistically analyzed using ANOVA and Tukey tests (α = 0.05). BR/US showed lower percentage of filling material in the lateral canals than and, BCS/US (p<0.05). BR/US resulted in a higher percentage of voids than BR in the lateral apical third (p<0.05). BCS showed higher flow than BR (p<0.05). BCS and BR presented proper filling capacity in the simulated curved canals regardless of the use of ultrasonic agitation. However, BR/US showed more voids in the apical third. BCS demonstrates higher filling ability.

Resumo Este estudo avaliou o efeito da agitação ultrassônica na capacidade de preenchimento de cimento pronto para uso à base de silicato de cálcio Bio-C Sealer (BCS, Angelus, Paraná, Brasil) ou pó-líquido BioRoot RCS (BR, Septodont, Saint-Maur -des-Fossés, França) utilizando canais artificiais curvos por microtomografia computadorizada (micro-CT). Adicionalmente, escoamento (mm) e área de escoamento (mm2) foram avaliados para ambos materiais. Please, replace the sentence highlighted in yellow to: O canal principal de resina acrílica (curvatura de 60° e raio de 5 mm, com 3 canais laterais nos terços cervical, médio e apical) foi preparado até o tamanho 40/.05 (Prodesign Logic, Brasil). O método de agitação foi utilizado com ponta ultrassônica (US, Irrisonic, Helse, Brasil): BCS, BCS/US, BR e BR/US. Todos os espécimes foram obturados usando a técnica de cone único. As amostras foram escaneadas por micro-CT (8,74 µm) após obturação. A porcentagem de material obturador e vazios foram calculados. O escoamento foi avaliado com base nas normas ISO 6876/2012 (mm) e área (mm2). Os dados foram analisados estatisticamente pelos testes ANOVA e Tukey (α = 0,05BR/US apresentou menor percentual de material obturador nos canais laterais que BCS e BCS/US (p<0,05). BR/US resultou em maior porcentagem de vazios que o BR no canal lateral do terço apical (p<0,05). BCS apresentou maior escoamento que BR (p<0,05)." BCS e BR apresentaram capacidade de preenchimento adequada nos canais curvos simulados independente do uso de agitação ultrassônica. No entanto, BR/US apresentou mais vazios no terço apical. BCS demonstra maior capacidade de preenchimento.

Influence of sealer and supplementary approach on filling material removal during endodontic retreatment

Abstract Both root canal sealer-based and supplementary protocols may influence removal of filling material during endodontic retreatment. Mesial root canals of extracted mandibular molars were prepared using HyFlex EDM 25/.08, and filled with a calcium silicate sealer (Bio-C Sealer), or an epoxy resin (AH Plus), using the single cone technique (n = 12). Retreatment was performed using ProDesign Logic (PDL) RT and PDL 35/.05. The specimens were randomly divided into two experimental groups (n = 12), and the sealers were distributed similarly. A supplementary protocol was performed with PDL 50/.01 or XP-endo Finisher. Root canal transportation and volume, in addition to the remaining filling material percentage were evaluated using high-resolution (5 µm voxel size) micro-CT. Statistical analysis was performed using t-tests (α = 0.05). Root canals filled with AH Plus presented high residual filling material (p < 0.05). Both protocols decreased residual volume of filling material in the apical third (p < 0.05). PDL 50/.01 increased the apical root canal volume (p < 0.05). No difference was observed between the systems regarding canal transportation (p > 0.05). In conclusion, AH Plus is more difficult to remove from the apical third than Bio-C Sealer. PDL 50/.01 and XP-endo Finisher enabled greater removal of filling materials in the apical third, in the retreatment of curved root canals, without promoting apical transport.

Effect of Endo-Z bur or Bladesonic ultrasonic tip on the adaptation of filling material. A micro-CT study.

This study aimed to evaluate the effect of apicoectomy performed with a bur or an ultrasonic tip on the adaptation of the filling material to root canal dentin. Twenty human mandibular incisors were selected and prepared with a ProDesign Logic system up to diameter 40/.05. The root canals were filled with Bio-C Sealer (Angelus, PR, Brazil) using the single cone technique and were stored at 37ºC and 95% relative humidity for 7 days. After this period, the apicoectomy of the 3 millimeters of the root apex was performed using Endo-Z bur (Dentsply Sirona) or Bladesonic ultrasonic tip (Helse Ultrasonic, Santa Rosa de Viterbo, Brazil) (n=10). The specimens were scanned by micro-computed tomography (micro-CT; SkyScan 1176) with a voxel size of 8.74 µm after obturation and after apicoectomy. The percentage of voids at the interface between the filling material and the root canal wall was evaluated in the apical 4 mm of the root after apicoectomy, besides the time cutting to both devices. The data obtained were submitted to paired and unpaired t-tests (α = 0.05). Endo-Z and Bladesonic increased the percentage of voids between the filling material and the dentin after apicectomy (p<0.05), and they were similar (p>0.05). Endo-Z has a shorter time to perform apicoectomy compared to Bladesonic (p<0.05). Apicectomies with Endo-Z or Bladesonic could harm the material/dentin interface, while the Endo-Z bur was faster than the Bladesonic ultrasonic tip.

Effect of Endo-Z bur or Bladesonic ultrasonic tip on the adaptation of filling material. A micro-CT study

Abstract This study aimed to evaluate the effect of apicoectomy performed with a bur or an ultrasonic tip on the adaptation of the filling material to root canal dentin. Twenty human mandibular incisors were selected and prepared with a ProDesign Logic system up to diameter 40/.05. The root canals were filled with Bio-C Sealer (Angelus, PR, Brazil) using the single cone technique and were stored at 37ºC and 95% relative humidity for 7 days. After this period, the apicoectomy of the 3 millimeters of the root apex was performed using Endo-Z bur (Dentsply Sirona) or Bladesonic ultrasonic tip (Helse Ultrasonic, Santa Rosa de Viterbo, Brazil) (n=10). The specimens were scanned by micro-computed tomography (micro-CT; SkyScan 1176) with a voxel size of 8.74 µm after obturation and after apicoectomy. The percentage of voids at the interface between the filling material and the root canal wall was evaluated in the apical 4 mm of the root after apicoectomy, besides the time cutting to both devices. The data obtained were submitted to paired and unpaired t-tests (α = 0.05). Endo-Z and Bladesonic increased the percentage of voids between the filling material and the dentin after apicectomy (p<0.05), and they were similar (p>0.05). Endo-Z has a shorter time to perform apicoectomy compared to Bladesonic (p<0.05). Apicectomies with Endo-Z or Bladesonic could harm the material/dentin interface, while the Endo-Z bur was faster than the Bladesonic ultrasonic tip.

Resumo O objetivo deste estudo foi avaliar o efeito da apicectomia realizada com broca ou inserto ultrassônico na adaptação do material obturador á dentina do canal radicular. Vinte incisivos inferiores humanos extraídos foram selecionados e preparados com o sistema ProDesign Logic até o diâmetro 40/.05. Os canais radiculares foram obturados com Bio-C Sealer (Angelus, PR, Brasil) por meio da técnica de cone único e foram armazenados em estufa a 37ºC e umidade relativa de 95% por 7 dias. Após esse período, foi realizada apicectomia dos 3 milímetros apicais utilizando broca Endo-Z (Maillefer - Dentsply) ou inserto ultrassônico BladeSonic (Helse Ultrasonic, Santa Rosa de Viterbo, Brasil) (n=10). Os espécimes foram escaneados por meio de microtomografia computadorizada (micro-CT; SkyScan 1176) com tamanho de voxel de 8,74 µm após obturação e após apicectomia. Please, correct this sentece to O percentual de falhas na interface entre o material obturador e a parede dentinaria foi avaliado nos 4 mm apicais da raiz apos apicectomia, alem do tempo de corte para ambos dispositivos. Os dados obtidos foram submetidos aos testes t pareado e não pareado (α = 0,05). Endo-Z e Bladesonic aumentaram o percentual de vazios entre o material obturador e a parede da dentina após apicectomia (p<0.05), sendo semelhantes entre si (p>0.05). Endo-Z demonstrou menor tempo para realizar apicectomia em comparação com Bladesonic (p<0.05). Apicectomias com Endo-Z ou Bladesonic podem prejudicar a interface material obturador/dentina, sendo a broca Endo-Z mais rápida que a ponta ultrassônica Bladesonic.

Análise de metodologias para avaliação da solubilidade do cimento à base de silicato de cálcio Bio-C Sealer / Analysis of methodologies for evaluating the solubility of calcium silicate-based sealer Bio-C Sealer

Introdução: Cimentos endodônticos à base de silicato de cálcio demonstram maior solubilidade em água destilada. Emprego de metodologias alternativas pode auxiliar em melhor compreensão sobre a solubilidade desses materiais. Objetivo: Avaliar o efeito da solução de imersão e do tipo de modelo experimental na solubilidade de cimento pronto para uso Bio-C Sealer. Material e método: Modelos circulares de polietileno ou dentina bovina (n = 16) foram confeccionados. Após inserção do cimento, os espécimes foram mantidos em estufa a 37 °C por 48 horas. Posteriormente, as amostras foram pesadas em balança de precisão para determinação da massa inicial. Na sequência, os espécimes foram imersos em 7,5 mL de água destilada (pH 6,5) ou PBS (pH 7,0) (n = 8) por 28 dias. Após isso, as amostras foram removidas das soluções e pesadas a cada 24 horas até a estabilização da massa final (0,001g). Corpos de prova confeccionados com Bio-C Sealer foram empregados como controle. A solubilidade foi avaliada de acordo com a diferença entre a massa inicial e final em porcentagem. Teste ANOVA Two-Way e teste post-hoc de Tukey foram realizados (α = 0,05). Resultado: Imersão em água destilada proporcionou maior solubilidade em comparação com PBS, independentemente do modelo experimental (p < 0,05). Corpos de prova apresentaram maior solubilidade, seguidos dos modelos de polietileno e dentina imersos em água destilada (p < 0,05). Não houve diferença entre os modelos experimentais imersos em PBS (p > 0,05). Conclusão: Bio-C Sealer apresenta solubilidade significativamente maior em água destilada do que em PBS em todas condições. Modelo experimental empregando dentina bovina e PBS como solução de imersão demonstra diminuir a perda de massa de Bio-C Sealer e pode ser uma alternativa valiosa para avaliar a solubilidade de cimentos biocerâmicos

Introduction: Calcium silicate-based sealers demonstrate greater solubility in distilled water. The use of alternative methodologies can help at better understanding the solubility of these materials. Objective: To evaluate the effect of the immersion solution and the type of experimental model on the solubility of readyto-use Bio-C Sealer. Material and method: Circular models of polyethylene or bovine dentin (n = 16) were made. After insertion of the sealer, the specimens were kept in an oven at 37°C and 95% humidity for 48h. Subsequently, the samples were weighed on a precision balance to determine the initial mass. Next, the specimens were immersed in 7.5 mL of distilled water (pH 6.5) or PBS (pH 7.0) (n = 8) for 28 days. After that, the samples were removed from the solutions and weighed every 24 hours until the final mass stabilized (0.001g). Test specimens made with Bio-C Sealer were used as a control. Solubility was evaluated according to the difference between the initial and final mass in percentage. Two-Way ANOVA test and Tukey post-hoc tests were performed (α=0.05). Result: Immersion in distilled water provided greater solubility compared to PBS regardless of the experimental model (p<0.05). The test specimens showed greater solubility, followed by polyethylene and dentin models immersed in distilled water (p<0.05). There was no difference between the experimental models immersed in PBS (p>0.05). Conclusion: Bio-C Sealer presents significantly greater solubility in distilled water than in PBS under all conditions. Experimental model using bovine dentin and PBS as an immersion solution demonstrates reduction in the mass loss of Bio-C Sealer and can be a valuable alternative for evaluating the solubility of bioceramic sealers

A new proposal for evaluating of the solubility of bioceramic materials in dentin tubes after immersion in PBS: a laboratory investigation / Nova proposta para avaliação da solubilidade de materiais biocerâmicos em tubos de dentina após imersão em PBS: um estudo laboratorial

Introdução: Materiais reparadores devem apresentar baixa solubilidade. Solução salina tamponada com fosfato (PBS) permite simular condição clínica e interação com dentina pode ser importante para correta avaliação da perda de massa de cimentos biocerâmicos. Objetivo: Avaliou o efeito da imersão em água destilada (AD) ou PBS na solubilidade de Bio-C Repair (BCR, Angelus) ou MTA Repair HP (MTAHP, Angelus) usando modelo de tubo de dentina. Material e método: Tubos de dentina bovina foram confeccionados com 4 mm de comprimento, 1,5 mm de diâmetro interno e 1 mm aproximadamente de espessura de parede. Os espécimes foram imersos em AD por 24h, posteriormente preenchidos com BCR ou MTAHP (n = 14) e armazenados em estufa a 37°C e umidade 95% por 24h. Após serem pesados em balança de precisão para determinação da massa inicial, os corpos de prova foram imersos em AD (pH 6,5) ou PBS (pH 7,0) (n = 7) por 28 dias. Tubos vazios também foram utilizados para o cálculo de perda de massa da dentina (n=4). Após esse período, os espécimes foram pesados até a estabilização da massa final (0,001g). A solubilidade de cada material foi avaliada. Testes estatísticos ANOVA e Tukey foram realizados (α=0,05). Resultado: BCR e MTAHP apresentaram ganho de massa em AD e perda de massa em PBS (p<0,05). Conclusão: A solução de imersão influencia a solubilidade de BCR e MTAHP usando modelo de tubo de dentina. Nova proposta metodológica poderá ser uma alternativa às normas ISO para testar a solubilidade de cimentos biocerâmicos

Introduction: Repair materials must have low solubility. Phosphate buffered saline (PBS) allows simulating clinical condition and interaction with dentin may be important for the correct evaluate of mass loss of bioceramic cements. Objective: To evaluate the effect of distilled water (DW), or PBS immersion on the solubility of Bio-C Repair (BCR, Angelus) or MTA Repair HP (MTAHP, Angelus) using a dentin tube model. Material and method: Bovine dentin tubes with a length of 4 mm, an internal diameter of 1.5 mm and walls thickness of approximately 1 mm were made. The specimens were immersed in DW for 24h, then filled with BCR or MTAHP (n = 14) and stored in an oven at 37°C and 95% humidity for 24h. After being weighed on a precision balance to determine the initial mass, the specimens were immersed in DW (pH 6.5) or PBS (pH 7.0) (n = 7) for 28 days. Empty tubes also were used for calculating the mass loss of the dentin (n=4). After this period, the specimens were weighed until stabilization of the final mass occurred (0.001g). The solubility of each material was evaluated. ANOVA and Tukey statistical tests were performed (α=0.05). Result: BCR and MTAHP showing gain of mass in DW and mass loss in PBS (p<0.05). Conclusion: The immersion solution influenced the solubility of BCR and MTAHP using dentin tube model. The new methodological proposal could be an alternative to ISO standards for testing the solubility of bioceramic cement