Bioactivity and biocompatibility of bioceramic sealers in endodontics: an integrative review

Introduction: Bioceramic sealers have been gaining prominence in endodontics, meaning a great advance for endodontic therapy, mainly due to their biocompatibility and bioactivity. Objectives: research and discuss the literature about the bioactivity and biocompatibility of bioceramic sealants. Materials and methods: An integrative review was performed. The systematic plan consisted of four steps. In the first stage, a bibliographic survey was carried out in the Capes Periódicos Portal database. The search criteria were articles published between 2017 and 2022, found in the "advanced search" mode, using cross-references with the following keywords: bioceramics sealers AND endodontology AND root canals AND endodontic sealer AND bioactivity AND biocompatibility. Only documents found and published in full were evaluated. In the second stage, the titles and abstracts of the articles were read. In the third stage, a selection was made of those containing 3 to 5 keywords and a wording equal to or close to the proposed keywords. The fourth step consisted of reading the texts in full, followed by checking for duplicity and building a table with the collected information. Results: In view of the research carried out, 23 articles were obtained in the first stage. After reading the titles and abstracts, 21 articles were obtained. After selecting those containing 3 to 5 keywords, 10 articles met the criteria. One article was deleted due to duplicates. 9 articles met the exclusion and inclusion criteria and were selected to be part of the integrative review. Discussion: The selected studies in this literature review showed that bioceramic endodontic sealants perform well in endodontic therapy. Conclusion: To advance in its clinical application, more in vivo and in vitro studies with precise methods are needed to obtain more reliable data about its properties.

NSK reciprocating handpiece: in vitro comparative analysis of dentinal removal during root canal preparation by different operators.

The purpose of this study was to assess dentin removal during root canal preparation by different operators using a NSK reciprocating handpiece. Eighty-four human single-rooted mandibular premolars were hand instrumented using Triple-Flex stainless-steel files (Kerr) up to #30, weighed in analytical balance and randomly assigned to 4 groups (n=21). All specimens were mechanically prepared at the working length with #35 to #45 Triple-Flex files (Kerr) coupled to a NSK (TEP-E10R, Nakanishi Inc.) reciprocating handpiece powered by an electric motor (Endo Plus; VK Driller). Groups 1 to 4 were prepared by a professor of Endodontics, an endodontist, a third-year dental student and a general dentist, respectively. Teeth were reweighed after root canal preparation. The difference between weights was calculated and the means of dentin removal in each group were analyzed statistically by ANOVA and Tukey's test at 5 % significance level. The greatest amount of dentin removal was found in group 4, followed by groups 2, 3 and 1. Group 4 differed statistically from the other groups regarding dentin removal means [p<0.001 (group 1); p=0.005 (group 2); and p=0.001 (group 3)]. No statistically significant difference was found between groups 1 and 2 (p=0.608), 1 and 3 (p=0.914) and 2 and 3 (p=0.938). In conclusion, although the group prepared by a general dentist differed statistically from the other groups in terms of amount of dentin removal, this difference was clinically irrelevant. The NSK reciprocating handpiece powered by an electric engine was proved an effective auxiliary tool in root canal preparation, regardless of the operator's skills.

NSK reciprocating handpiece: in vitro comparative analysis of dentinal removal during root canal preparation by different operators

Este estudo avaliou a perda de massa dentinária durante o preparo do canal radicular por 4 diferentes operadores utilizando o sistema de rotação alternada NSK (TEP-E10R, Nakanishi Inc.). Após a instrumentação manual de 84 pré-molares inferiores humanos com limas de aço inoxidável Triple-Flex (Kerr) até a lima #30, os espécimes foram pesados e divididos aleatoriamente em 4 grupos (n=21). Os canais foram preparados mecanicamente até o comprimento de trabalho com limas Triple-Flex #35 a #45 acopladas ao sistema de rotação alternada NSK acionado por motor elétrico (Endo Plus; VK Driller). Os grupos 1 a 4 foram preparados por professor de Endodontia, um endodontista, um estudante do 3º ano de Odontologia e um clínico geral, respectivamente. Após o preparo mecânico, os espécimes foram novamente pesados. A diferença entre o peso inicial e o peso final foi obtida e as médias de perda de massa dentinária em cada grupo foram submetidas à análise estatística por meio da ANOVA e Teste de Tukey com nível de significância de 5%. A maior quantidade de perda de massa dentinária foi observada no grupo 4, seguido pelos grupos 2, 3 e 1. Houve diferença estatisticamente significante o grupo 4 e os outros três grupos [p<0,001 (grupo 1); p=0,005 (grupo 2) e p=0,001 (grupo 3)]. Não houve diferença estatisticamente significante entre os grupos 1 e 2 (p=0,608), 1 e 3 (p=0,914) e 2 e 3 (p=0,938). Conclui-se que embora o grupo preparado pelo clínico geral tenha diferido estatisticamente dos demais grupos em termos de quantidade de dentina removida, essa diferença não foi clinicamente relevante. O sistema de rotação alternada NSK mostrou-se um recurso auxiliar eficiente no preparo do canal radicular, independentemente da experiência do operador.