Effect of heat application on the physicochemical properties of new endodontic sealers: an in vitro and SEM study.

Understanding the properties of endodontic sealers is vital for treatment planning. Calcium silicate-based sealers are important in modern endodontics. This study investigates the effect of heat on the physicochemical properties of new calcium silicate sealers, addressing concerns raised by clinicians seeking to combine their benefits with the gutta-percha obturation technique. Five endodontic sealers (AH Plus Bioceramic®, Total Fill® BC®, One-fil® Bioceramic, K-Biocer, Any-seal®) were evaluated. Each sealer (n = 16/group) was either kept at 37 °C or subjected to heat at 60 or 200 °C for 30 s. ISO 6876-2012 standards were used to measure setting time, flow, film thickness, and dimensional changes over time. SEM and EDS were utilized for surface and chemical analysis. Data analysis employed IBM SPSS Statistics version 26 with a 5% significance level for two-sided tests. The sealers' setting times were shortened by heat, except for Total Fill® BC with extended setting time. All sealers had significantly longer setting times than manufacturer specifications. Film thickness increased with temperature, while flow values decreased. K-Biocer sealer showed the highest flow (16.89 ± 0.57 mm) at 200 °C, while Total Fill® sealer had the lowest (15.32 ± 0.62 mm). Shrinkage was significant at 60 °C and 200 °C, with greater shrinkage at 200 °C. Heat caused surface deformations in all sealers. The 200 °C groups exhibited more voids in AH Plus Bioceramic®, Any-seal®, and One-fil® sealers, and higher void area in Total Fill®, One-fil®, and K-Biocer sealers (p value < 0.001). EDX analysis confirmed heat-induced chemical and elemental changes in all tested sealers. Elevated temperature affects the physicochemical properties and structure of the tested endodontic sealers. The consideration of endodontic sealer compatibility is essential when warm gutta-percha obturation techniques are used.

The Pushout Bond Strength of Three Calcium Silicate-based Materials in Furcal Perforation Repair and the Effect of a Novel Irrigation Solution: A Comparative In Vitro Study.

AIM: To evaluate the pushout bond strength of three calcium silicate-based materials used as furcal perforation repair materials and the effect of root canal irrigants on the pushout strength of the tested repair materials. MATERIALS AND METHODS: Furcal perforations measuring 1.3 mm in diameter were made in the center of the furcation area of 90 extracted human mandibular molars. The teeth were then randomly divided into three groups (n = 30) according to the repair material: Biodentine (Septodont, St-Maur-des-Fossés, France), PD-MTA White (Produits Dentaires, Vevey, Switzerland), and K-Biocer (REKITA, Lebanon). The specimens were stored at 100% humidity at 37°C for 72 hours. They were later divided into three subgroups (n = 10) based on the irrigation protocol: 2.5% sodium hypochlorite, BioAKT (Metabolic substrate, New Tech Solutions s.r.l., Brescia, Italy), and a control group. After incubation for 48 hours, the dislodgement resistance of the samples was measured using a universal testing machine. RESULTS: The mean bond strength was significantly different between repair materials in the irrigation control group (p-value <0.001). With PD-MTA White and K-Biocer, the mean bond strength was not significantly different between irrigation groups (p-value = 0.681). The mean bond strength of Biodentine was significantly different between irrigation groups (p-value = 0.002); it was the highest with BioAKT. CONCLUSION: Biodentine showed a high performance as a perforation repair material and its resistance to dislocation increased after being exposed to BioAKT. K-Biocer had the lowest pushout bond strength. PD-MTA White showed intermediate bond strength and was not affected by the tested irrigants. CLINICAL SIGNIFICANCE: The bond strength of endodontic materials to root dentin is an important factor to consider for long-term clinical success since the teeth are constantly subjected to masticatory forces.

Shaping ability of a new heat-treated NiTi system in continuous rotation or reciprocation in artificial curved canals.

The purpose is to evaluate canal transportation of a new heat-treated NiTi system, the Endostar E3 Azure operated in continuous rotation or reciprocation. 40 resin blocks were divided into two groups. The first was shaped in continuous rotation while the second in reciprocation. A preoperative and two postoperative images were taken, one after the use of the 20/06 and one after the 25/06. The images were superimposed to determine canal transportation. Time required for canal shaping was recorded. One-sample and student t tests, repeated-measure analyses of variance, univariate analyses and Bonferroni multiple comparisons tests were used for statistical analysis. The significance level was set at p < 0.05. There was no significant difference between continuous and reciprocating motion with the 20/06 and 25/06, respectively, at 1 mm (p = 0.761, p = 0.559), 2 mm (p = 0.584, p = 0.810) and 3 mm (p = 0.651, p = 0.070). The reciprocating motion showed significantly less canal transportation at 5 mm (p = 0.049, p < 0.001) and 7 mm (p < 0.001, p < 0.001) for the 20/06 and 25/0.6. Continuous rotation was more time-consuming than reciprocation (p < 0.001). The Endostar E3 Azure in reciprocation respected the original canal curvature better than in continuous rotation at all levels, and required less time to prepare artificial curved canals. Endodontists should know the shaping abilities of novel heat-treated NiTi files, regarding canal transportation and its relation with the instruments' motion and apical diameter enlargement.

Guided Endodontic Treatment of Calcified Lower Incisors: A Case Report.

A 52-year-old female patient was diagnosed with chronic periapical periodontitis associated with severely calcified lower central incisors. Radiographic examination revealed no visible root canal in the coronal-third of the root. After choosing the guided endodontic treatment, an intraoral scan (Trios, 3shape, Copenhagen, Denmark), in conjunction with a cone beam computed tomography (CBCT) scan, was taken in order to design and fabricate a printed guide. Virtual implant software was used to visualize the surgical access into the sclerosed root canals. After locating the canals, the guide was removed, and the teeth were treated under a rubber dam. The guided approach allows predictable, efficient endodontic treatment of teeth presenting calcified canals, with minimal removal of sound dentine and less risk of root perforations.

Sealing Ability of Calcium Silicate-based Materials in the Repair of Furcal Perforations: A Laboratory Comparative Study.

AIM: To assess the sealing ability of two calcium silicate-based materials in the treatment of iatrogenic furcal perforations using a dye-penetration leakage model. MATERIALS AND METHODS: Furcation perforations were performed using a size 12 round burr on the pulp chamber floor of 20 first mandibular molars. The teeth were then randomly divided into two groups, two additional molars served as negative controls. The defects were then filled with mineral trioxide aggregate (MTA) Angelus in the first group and Biodentine in the second group. Leakage at the repaired sites was then evaluated using the methylene blue dye penetration technique. RESULTS: Significant differences in microleakage were found between the two groups at 72 hours (p < 0.001). MTA Angelus had greater dye penetration than Biodentine with a statistically significant difference. Subsequently, the sealing ability of Biodentine was significantly better than MTA Angelus (p < 0.001). However, the mean values of leakage and inadequate adhesion were significantly different from the theoretical value for both the MTA Angelus (p < 0.001) and Biodentine (p < 0.001). CONCLUSION: The current results suggested that Biodentine possesses higher sealing quality than MTA Angelus. Yet, both materials are not ideal and still need improvement to ensure perfect adhesion in case of furcal perforation. CLINICAL SIGNIFICANCE: This article aims to compare the sealing ability of one dental repair material over another, after iatrogenically producing a furcal perforation. Leakage resistance and sealing ability are important factors in favoring the outcome of an endodontic treatment of a tooth that could otherwise be condemned for extraction.