Propiedades físicas de utilidad clínica de los nuevos cementos selladores de endodoncia a base de silicatos. Revisión bibliográfica / Clinically useful properties of new silicate-based endodontic sealers. A literature review

Introducción: La obturación del sistema de conductos presenta un papel clave en el éxito del tratamiento de endodoncia. En un intento de mejorar las propiedades de los cementos selladores, recientemente se han introducido en el mercado los cementos selladores a base de silicatos. Por ello, al llevar a cabo la obturación del sistema de conductos, es de utilidad conocer las propiedades físicas que los diferentes cementos selladores presentan. Objetivo: El objetivo del presente trabajo fue la revisión bibliográfi ca de las propiedades físicas de utilidad clínica que presentan los nuevos cementos a base de silicatos, y compararlas con las propiedades físicas de los cementos convencionales a base de resina epóxica. Material y método: Tras establecer la pregunta de investigación adaptada, se llevó a cabo una revisión de la literatura en dos bases de datos (Medline vía Pubmed y Wiley Library vía Biblioteca Chrocane) combinando términos MeSH (Medical Subject Headings) y términos libres. Además, se llevó a cabo una búsqueda electrónica manual. Las propiedades físicas de utilidad clínica seleccionadas fueron la decoloración, capacidad de sellado, radiopacidad, tiempo de fraguado y solubilidad. Resultados: Se obtuvieron 224 estudios potenciales. Finalmente, aplicando los criterios de inclusión y exclusión, se incluyeron 22 estudios en la revisión. Los distintos estudios compararon diferentes propiedades físicas de los cementos a base de silicatos, comparándolos con los cementos a base de resina. (AU)

Introduction: In the endodontic treatment success, the fi lling of the root canal system plays a key role. To improve properties of the sealers used in these treatments, new silicate-based sealers have recently been introduced into the market. Therefore, when performing the endodontic treatment, it is useful to know the physical properties of the different sealers. Objectives: The aim of the present study was to review the literature and compare the clinically useful physical properties of the new silicate-based cements with the physical properties of conventional epoxy resin-based cements. Methods: After establishing the adapted research question, a literature review was carried out in two databases (Medline via Pubmed and Wiley Library via Chrocane Library) combining MeSH (Medical Subject Headings) and free terms. In addition, a manual electronic search was performed. The clinically useful physical properties selected were discolouration, sealability, radiopacity, setting time and solubility. Results: A total of 224 potential studies were obtained and 20 were selected for full text reading. Additionally, 4 studies were selected through electronic handsearching. After exclusion of 2 studies, 22 studies were fi nally included in the review, which analyzed the following physical properties: 2 tooth discolouration; 4 sealing ability; 11 radiopacity; 9 setting time; and 12 solubility. 9 of the selected articles evaluated several properties. (AU)

Cementos de silicato de calcio: evaluación de la toxicidad y de la respuesta inflamatoria / Calcium silicate-based sealers: cytotoxicity and inflammatory evaluation

La biocompatibilidad de los cementos selladores es una característica que debe tenerse en cuenta, ya que podría influir en el resultado del tratamiento de conductos. El objetivo de este estudio fue analizar la citotoxicidad de los cementos selladores a base de silicatos BioRoot® RCS y Nano-ceramic Sealer®, y el sellador a base de resina epóxica AH Plus Jet®, así como su respuesta inflamatoria asociada en fibroblastos humanos. Se seleccionaron 36 dientes unirradiculares, se instrumentaron y obturaron con los selladores seleccionados. A continuación, se pusieron en contacto con el medio de cultivo para obtener los medios acondicionados a las 24, 48 y 72 horas. Los medios acondicionados obtenidos fueron cultivados con la línea celular de fibroblastos L-132. La viabilidad de las células se evaluó mediante el ensayo del bromuro de 3-(4,5-dimetiltiazol-2-il)-2,5 difenil tetrazolio (MTT). La respuesta inflamatoria se analizó mediante la medición de los niveles de IL-6 determinados a través del ensayo ELISA (ensayo por inmunoabsorción ligado a enzimas) y mediante los niveles de nitrito (ensayo de fluorescencia). Todos los selladores mostraron un cierto grado de citotoxicidad durante el tiempo de evaluación, mientras que sólo el BioRoot® RCS desencadenó una respuesta pro-inflamatoria. Es necesario seguir investigando para evaluar otros aspectos de la biocompatibilidad de los cementos selladores a base de silicato. (AU)

Biocompatibility of sealers is a feature to be taken into account as it might influence the outcome of the treatment. The aim of this study was to analyze the cytotoxicity of the silicate-based root canal sealers BioRoot™ RCS and Nanoceramic Sealer™and the epoxy-resin based sealer AH Plus Jet™, as well as their associated inflammatory response in human fibroblast. Thirty-six human teeth were selected, prepared, filled with the selected sealers and put in contact with culture medium to obtain extracts at 24, 48 and 72 hours. Then, the extracts were cultured with the L-132 fibroblast cell line. Cell viability was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyl tetrazolium bromide (MTT) assay. Inflammatory response was analyzed by measuring IL-6 levels determined by ELISA and nitrite levels (fluorescence assay). All sealers showed a certain degree of cytotoxicity during the evaluation time, while only the BioRoot™ RCS triggered a pro-inflammatory response. Further research is needed to assess other aspects of biocompatibility of silicate-based root canal sealers. (AU)

Clinical utility properties of new endodontic silicate-based sealers: a systematic review

Introduction: Filling in the root canal system plays a key role in the success of endodontic treatment. New silicate-based sealers have recently been introduced on the market to improve the properties of sealers used in these treatments. Before performing endodontic treatment, it is always useful to know the properties of different sealers. Objectives: The aim of this study was to review the literature and compare the clinically useful properties of new silicate-based sealers with those of conventional epoxy resin-based cements. Methods: After establishing the adapted research question, a literature review was carried out in two databases (Medline via Pubmed and Wiley Library via Cochrane Library) combining MeSH (Medical Subject Headings) and free terms. A manual electronic search was also performed. The clinically useful properties selected were discolouration, sealing capacity, radiopacity, setting time and solubility. Results: Of the 224 potential studies obtained, 20 were selected for reading of the full text. Another 4 studies were selected after manual electronic searching of which 2 were excluded, leaving 22 studies for inclusion in the review. The following physical properties were analysed: 2 for tooth discolouration; 4 for sealing ability; 11 for radiopacity; 9 for setting time; and 12 for solubility; 9 of the articles evaluated several properties. Conclusions: No differences in tooth discolouration were observed between silicate-based and resin sealers. No differences in sealing ability were observed in most of the studies consulted. All sealers analysed showed radiopacity values within the recommended standards. Both setting time and solubility depended on the type of sealer; with some of the silicate-based sealers having higher solubility than the resin-based. (AU)