Comparative Evaluation of the Sealing Ability of Mineral Trioxide Aggregate (MTA)-Based, Resin-Based, and Zinc Oxide Eugenol Root Canal Sealers: An In Vitro Study.

Root canal therapy is a crucial procedure in endodontics that is done to achieve complete obliteration of the root canal space. The success of this therapy depends on achieving a proper seal, which is facilitated using root canal sealers. This study aimed to compare the apical sealing ability of three different root canal sealers: MTA Fillapex, AH Plus, and zinc oxide eugenol (ZOE), using the dye penetration method. Forty freshly extracted single-rooted human maxillary incisors were collected and prepared for the study. The root canals were instrumented using the ProTaper system, and the canals were then obturated using the lateral condensation technique with the respective sealers. After one week of storage, the samples were coated with nail varnish, immersed in a rhodamine B dye solution, and then sectioned longitudinally. The depth of dye penetration was measured, and the results were analyzed statistically. The results revealed significant differences in apical leakage among the three experimental groups. Group 2 (AH Plus) showed the minimum leakage with a mean of 0.13 mm, while Group 4 (no sealer) exhibited the maximum leakage with a mean of 4.49 mm. Group 3 (ZOE) showed an intermediate level of leakage with a mean of 2.37 mm. The statistical analysis confirmed the significant difference in mean leakage among the groups. The findings of this study indicate that AH Plus exhibited superior apical sealing ability compared to MTA Fillapex and ZOE. AH Plus is a resin-based sealer known for its dimensional stability. On the other hand, MTA Fillapex, a newly introduced sealer containing mineral trioxide aggregate, resin, and silica, showed promising sealing properties but had slightly higher leakage compared to AH Plus. ZOE, a traditional sealer, demonstrated relatively higher leakage than the other sealers. In conclusion, choosing a root canal sealer is crucial in achieving a successful endodontic treatment outcome. AH Plus demonstrated superior apical sealing ability among the three sealers tested. Further research and long-term clinical studies are warranted to validate these findings and assess the impact of sealer choice on treatment outcomes and post-endodontic healing.

In vitro toxicogenomic activity of an MTA/salicylate-based endodontic sealer.

This study was designed to investigate whether mineral trioxide aggregate (MTA) Fillapex®, an MTA/salicylate-based endodontic sealer, exerts cytotoxic and toxicogenomic effects on human gingival fibroblasts (HGFs). HGFs were exposed in vitro to MTA Fillapex® at concentrations of 5%, 10%, 20%, and 40% for 24 h. Cytotoxicity, cell survival (5 days), cell cycle kinetics (flow cytometry), genotoxicity (comet assay), and gene (TP53, BAX, and BCL2) expression profiles were evaluated using reverse-transcriptase quantitative polymerase chain reaction. MTA Fillapex® was cytotoxic to HGFs at the two highest concentrations (20% and 40%), and cell survival decreased after 5 days treatment only with 40% concentration. After MTA Fillapex® treatment, there was an increase in the expression of apoptosis-related genes BAX, BCL2, and TP53, but no increase in DNA damage. Cement also induced changes in cell cycle kinetics, apoptosis, and necrosis rates. The data show the ability of MTA Fillapex® endodontic sealer to induce cellular and genetic alterations in HGFs. Our findings suggest that this compound should be used with caution to avoid health-related risks to the buccal tissue.

Evaluation of The Sealing Ability of Gutta Percha with Bioroot RCS, MTA Fillapex and Sealapex - An SEM Study.

Aim of the Study: The objective of this in-vitro study was to assess the screening capabilities of three endodontic sealers, namely the BioRoot RCS, the MTA Fillapex, and Sealapex (a calcium hydroxide-based sealer), and the gutta-percha cone by using a scanning electron microscopy to the dentine walls. The results from the research are presented here. Results: ZOE exhibited more gaps in the sealing materials evaluated with the least dental sealing performance, followed by the cervical third by the MTA Fillapex, the Sealapex, and the BioRoot RCS. The ZOE, followed by Sealapex, MTA Fillapex, and BioRoot RCS, exhibited inadequate dental wall sealing capacity in the middle of the third. The third apical ZOE exhibited more deficiencies in the formation of dental walls, followed by Sealapex, MTA Fillapex, and BioRoot RCS. Conclusion: Under the constraints of the investigation, it can be stated that for the bioceramic sealer, a minimal gap was seen, with RCS of BioRoot superior to Fillapex of MTA. In the middle third, Sealapex was better adapted to the calcium hydroxide-based sealant than the MTA Fillapex sealer. MTA Filllapex had lower gap development than Sealapex in cervical or apical thirds.

The Effect of Primary Root Canal Treatment on Dentinal Tubule Penetration of Calcium Silicate-based Sealers during Endodontic Retreatment.

INTRODUCTION: The aim of this study was to evaluate the effect of previous root canal treatment on dentinal tubule penetration of calcium silicate-based sealers during endodontic retreatment and to compare 2 different (commonly used and modified) tubule penetration depth measurement techniques. METHODS: The crowns of mandibular premolar teeth were removed, and root canals were prepared (ProTaper Universal; Dentsply Sirona, York, PA) and obturated using AH Plus (AH; Dentsply DeTrey, Konstanz, Germany), MTA Fillapex (MTAF; Angelus, Londrina, Brazil), and WellRoot ST (WRST; Vericom, Gyeonggi-do, South Korea); 0.1% red Rhod-2 dye (Chemodex, St Gallen, Switzerland) was added to the sealers. After storage for 3 weeks (37°C, 100% humid), the following sealer combination subgroups were created (the sealer used during the primary root canal treatment/the sealer used during the retreatment, n = 8): AH/AH, AH/MTAF, and AH/WRST; MTAF/AH, MTAF/MTAF, and MTAF/WRST; and WRST/AH, WRST/MTAF, and WRST/WRST. Green Fluo-3 dye (0.1%) was added to the sealers during retreatment. Sealer penetration depths were measured at 8 points and averaged, and the ratio of the retreatment sealer to the initial sealer was recorded as the mean tubule penetration depth ratio in the first technique, whereas the percentage of the circumferential penetration area ratios of the retreatment and initial sealers was calculated in the second technique. Statistical analyses were performed using Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests. RESULTS: The mean penetration depth of AH and MTFA was found to be higher at the coronal third region in the control groups (P < .05). Both methods showed a significant difference among the groups at the coronal and median regions (P < .05). The AH/WRST, MTAH/AH, MTAF/MTAF, MTAF/WRSTS, and WRST/WRST groups showed deeper tubule penetration (first technique, P = .01). Both techniques showed that the penetration depth of the sealers was the same at the apical region (P > .05), whereas a difference was found among the techniques at the coronal and median regions. The sealers used in the previous root canal treatment limited the penetration depth of the sealers used during the retreatment process (P < .05). When MTAF was used as the initial sealer, the penetration depth of the second sealer did not change, whereas if WRST was the initial sealer, the penetration depth of the sealers at the median and apical regions is negatively affected during the retreatment process (P < .05). CONCLUSIONS: Previous root canal treatment affects the penetration depth of calcium silicate-based sealers. The use of AH Plus and MTA Fillapex during the retreatment process showed an advantage. Both measurement techniques showed similar performances at the apical region, whereas the results varied at the coronal and midcoronal regions; therefore, a more stable sealer penetration measurement technique is still necessary.

The effect of four different intracanal medicaments on the push-out bond strength of root canal sealers.

This study aimed to compare the effect of 4 different intracanal medicaments on the push-out bond strength of two sealers (AH Plus and MTA Fillapex). 100 single-rooted extracted premolar teeth were divided into 5 groups, with 20 samples in each group, one group being the control group. After cleaning and shaping procedures, the canals were filled with 4 different medicaments: calcium hydroxide, tri-antibiotic paste (TAP), Metapex, or Chlorhexidine (2%) gel for 2 weeks. Following this, the medicaments were rinsed away, and the samples in those sub-groups were obturated with gutta-percha/AH Plus or MTA Fillapex sealers. After 2 weeks of incubation, a 2-mm-thick middle section from each root was evaluated to test push-out strength. The obtained data were tabulated, and appropriate statistical analysis was performed (two-way ANOVA and LSD test). When comparing the average values, the bond strength values of AH Plus were significantly higher than those of MTA Fillapex (p<0.05) in all medicament groups. Based on the findings, we concluded that AH Plus had comparatively higher bond strength than MTA Fillapex. We also observed that AH Plus had higher bond strength in the presence of calcium hydroxide, whereas MTA Fillapex in the presence of Chlorhexidine. A comparison of the push-out bond strength shows that irrespective of the root canal segment or the final irrigant used, AH Plus showed higher values among all groups. The limitation of the current study was that the effect of TAP on the bond strength of endodontic sealers was not negative.

Bone repair in defects filled with AH Plus sealer and different concentrations of MTA: a study in rat tibiae.

OBJECTIVES: This study aimed to evaluate the effects on bone repair of different concentrations of mineral trioxide aggregate (MTA) added to AH Plus. MATERIALS AND METHODS: Bone tissue reactions were evaluated in 30 rats (Rattus norvegicus) after 7 and 30 days. In the AH + MTA10, AH + MTA20, and AH + MTA30 groups, defects in the tibiae were filled with AH Plus with MTA in proportions of 10%, 20% and 30%, respectively; in the MTA-FILL group, MTA Fillapex was used; and in the control group, no sealer was used. The samples were histologically analyzed to assess bone union and maturation. The Kruskal-Wallis and Mann-Whitney tests were performed for multiple pairwise comparisons (p ≤ 0.05). RESULTS: At the 7-day time point, AH + MTA10 was superior to MTA-FILL with respect to bone union, and AH + MTA20 was superior to MTA-FILL with respect to bone maturity (p < 0.05). At the 30-day time point, both the AH + MTA10 and AH + MTA20 experimental sealers were superior not only to MTA-FILL, but also to AH + MTA30 with respect to both parameters (p < 0.05). The results of the AH + MTA10 and AH + MTA20 groups were superior to those of the control group for both parameters and experimental time points (p < 0.05). CONCLUSIONS: The results suggest the potential benefit of using a combination of these materials in situations requiring bone repair.

Data on the push-out bond strength of three different root canal treatment sealers.

It is of interest to document data on the push - out bond strength of three different root canal treatment sealers such as MTA Fillapex (MTA based), AH plus (Epoxy Resin based) and Apexit plus (Calcium hydroxide based). Forty-five freshly extracted human maxillary central incisors with closed apices were selected randomly. All the teeth were sectioned at cement-enamel junction using a diamond disc before starting the root canal preparation to obtain root length of 12 mm. All teeth were instrumented using ProTaper rotary instruments. 5.25% sodium hypochlorite was used for irrigation between instrumentation followed by 17% EDTA, and final rinse by saline. Obturation procedures were done using the gutta-percha single cone technique. 45 roots were randomly assigned to 3 groups of 15 for obturation with gutta-percha cones and 1 of the 3 sealers (n=15). Group 1 = MTA Fillapex sealer + gutta-percha: Group 2 = AH plus sealer + gutta-percha:Group 3 = Apexit plus sealer + gutta-percha. The roots were sectioned horizontally to its canal into 3 sections: Coronal, Mid-root and Apical-thirds using a precision cutting machine, with a thickness of 3 mm. The specimens were subjected to push-out test using a universal testing machine that carried a plunger. The loading speed was 1mm/min until the dislodgment of the material occurred. The independent t- test was used to compare the mean scores among the study groups. The level of significance was set at 5% for all tests. After the push-out bond strength test, each sample was evaluated under stereomicroscope (40x) to determine the mode of failure and recorded as one of the following categories: adhesive, cohesive or mixed. The observations thus obtained were subjected to statistical analysis using Student - t test. AH Plus showed significantly higher values than MTA Fillapex and Apexit plus (p < 0.05). Amongst the push-out bond strength AH Plus sealer showed significant difference from MTA Fillapex and Apexit plus groups. There was no significant difference between MTA Fillapex and Apexit plus however (p>0.05). Microscopic analysis displayed that the majority of the modes were cohesive failures for AH Plus, adhesive failures for MTA Fillapex and mixed failures for Apexit Plus. . Thus, AH Plus had the highest bond strength and MTA Fillapex had the lowest bond strength to root dentin. Mean push-out bond strength values were ranked as follows; AH Plus >Apexit Plus > MTA Fillapex. Microscopic analysis displayed that the majority of the modes were cohesive failures of AH Plus, adhesive failures for MTA Fillapex and mixed failures for Apexit Plus.

Comparative evaluation of retreatability of calcium silicate-based root canal sealers and epoxy resin-based root canal sealers in curved canals-An In-Vitro micro-CT analysis.

OBJECTIVE: To compare and evaluate the retreatability of calcium silicate-based root canal sealers and epoxy resin-based root canal sealers in curved canals using micro-CT scanning. MATERIALS AND METHODS: Forty-five maxillary molars with curved roots were selected after confirming with the Schneiders test. Teeth were decoronated near the cemento-enamel junction and moderate to severely curved canals were selected for the study using cone-beam computed tomography. All the samples were subjected to pre-operative micro-CT scanning. Cleaning and shaping were done using step-back preparation, obturation was done using lateral compaction technique, and homogeneous obturation was achieved. All the specimens were kept in 10 mL of phosphate buffered-saline solution at a pH of 8.4 for 48 h and transferred to a plastic container containing moistened foam with 10 mL of phosphate- buffered saline solution, and stored at 37 °C with 100% relative humidity for 4 months. Retreatment was performed for all the samples using Protaper universal retreatment files. Micro-CT scanning was performed to compare and evaluate the remaining sealer volume and resultant cracks formed in the root canal after retreatment. RESULTS: The volume of sealer remaining in the root canal and the length of a crack within the groups were analysed using kruskal-Wallis test and among the groups using post-hoc scheffe test showed that more sealer present in the Diaproseal sealer followed by MTA Fillapex and Bioroot RCS and more crack length was seen in Diaproseal sealer followed by MTA Fillapex and no visible cracks were seen in Bioroot RCS, which had statistically significant results with a P value of < 0.05. CONCLUSION: Within the limitations of the study it was concluded that in-terms of retrievability, Diaproseal sealer was the best among the tested groups followed by MTA Fillapex and Bioroot RCS.

Influence of adjunctive photodynamic therapy (curcumin) on the extrusion bond strength of radicular dentin to contemporary root canal sealers.

OBJECTIVE: The aim was to compare Photodynamic therapy (PDT) as an adjunct to NaOCl and EDTA on the extrusion bond strength (EBS) of AH Plus (AH), Sealapex (SA) and MTA Fillapex (MF) root canal sealers. MATERIALS AND METHOD: Root canal treatment for human teeth (n = 60) using protaper universal system was performed followed by irrigation with NaOCl/ EDTA. Samples were divided (n = 30) based on disinfection technique, NaOCl/EDTA and NaOCl/EDTA with PDT (Curcumin-PS-CP) as an adjunct. Specimens were divided in three subgroups (n = 10) based on sealers used (Gp 1-Na-E-AH, Gp 2-Na-E-PDT-AH, Gp 3-Na-E-SA, Gp 4-Na-E-PDT-SA, Gp 5-Na-E-MF & Gp 6-Na-E-PDT-MF). Canals were dried and obturated followed by sectioning at coronal and middle third. EBS testing was performed using a universal testing machine (UTM) and modes of failure were assessed. Analysis of variance (ANOVA) and Tukey multiple comparison tests were used to compare the means of EBS. (p < 0.05). RESULTS: Sealers showed a significant influence on EBS, as Gp 1 (Co: 9.21 ± 0.62, Mid: 8.54 ± 0.55) and Gp 2 (Co: 7.11 ± 0.68, Mid: 7.30 ± 0.37) showed higher EBS than Gp 3 (Co: 5.21 ± 0.63, Mid: 4.36 ± 0.83) and Gp 4 (Co: 5.39 ± 0.72, Mid: 4.46 ± 0.74). Gp 5 (Co: 9.04 ± 0.13, Mid: 8.14 ± 0.91) and Gp 6 (Co: 8.67 ± 0.42, Mid: 8.07 ± 0.07) exhibited higher EBS than Gp 3 and Gp 4 specimens. Adjunctive use of PDT for AH sealer (Gp 2) showed decreased EBS compared to Gp 1 specimens. EBS remained comparable for both MTA-Fillapex and Sealapex with and without PDT. CONCLUSION: AH Plus (Gp 1 and 2) and MTA-Fillapex (Gp 5 and 6) sealers displayed better EBS compared to Sealapex (Group 3 and 4). Adjunctive Application of PDT (CP) did not show a significant improvement in bond strength of sealers to root dentin.

Evaluación de la actividad antimicrobiana del MTA fillapex® frente al enterococcus faecalis / Evaluation of the Antimicrobial Activity of MTA Fillapex® Against Enterococcus Faecalis

RESUMEN Introducción: El objetivo final de la terapia endodóntica es la eliminación de microorganismos en el interior del conducto radicular. Algunas bacterias pueden sobrevivir a esta terapia; entre las comúnmente detectadas en fallas endodónticas se encuentra el E. faecalis. Los cementos biocerámicos se presentan como una alternativa eiciente en la terapia de endodoncia debido a su capacidad de sellado y sus propiedades antimicrobianas. Métodos: Estudio experimental in vitro, en el que se sembró la bacteria (E. faecalis) en una caja de Petri, se tomaron de 5 a 10 cepas y se disolvieron en caldo de Mueller Hinton, para luego depositar el inóculo más el cemento en diferentes concentraciones en una placa de 96 pozos y medir el nivel de absorbancia de cada muestra en un espectrofotómetro. Para el análisis estadístico se utilizaron las pruebas no paramétricas de Mann-Whitney y Kruskal Wallis. Resultados: Al comparar de dos en dos los datos obtenidos no se obtuvieron datos estadísticamente signiicativos, pero al comparar las diferentes concentraciones de ambos cementos se obtuvo que el cemento de Grossman al 2 % tiene mayor efecto antimicrobiano. Conclusión: No hay diferencia significativa en la actividad antimicrobiana del MTA Fillapex® y el cemento de Grossman contra el E. faecalis, pero al comparar el cemento de Grossman al 2 %, este tiene mayor efecto antimicrobiano en comparación con el mismo cemento a diversas concentraciones.

ABSTRACT Introduction: the ultimate aim of the root canal therapy is elimination or reduction of microorganisms in the root canal system. Although some bacteria can survive this therapy, among bacteria commonly detected in endodontic failure is E. faecalis. The bioceramic sealers are presented as an efficient alternative due its sealing capacity and antimicrobial properties. Methods: the research was experimental in vitro, where the bacteria (E. faecalis) was planted in a box perti, were taken from 5 to 10 strains and dissolved in broth Mueller Hinton then deposit inoculum more sealer at different concentrations in a 96 well plate and measuring the level of absorbance of each sample in a spectrophotometer. For statistical analysis, non-parametric Mann-Whitney and Kruskal Wallis were used. Results: when comparing two at the data no statistically significant data were obtained, but when comparing different concentrations of both sealers was obtained Grossman sealers 2% has greater antimicrobial effect. Conclusion: There is not significant difference in the antimicrobial activity of MTA Fillapex and Grossman cement against E. faecalis, but when comparing Grossman cement to 2%, this has a higher antimicrobial effect compared to the same cement at various concentrations.

The presence of smear layer affects the antimicrobial action of root canal sealers.

AIM: To assess the chemical and microstructural characteristics of dentine after the use of two irrigation protocols and correlate this with the antimicrobial properties of hydraulic calcium silicate cement (HCSC) sealers and changes to the dentine structure/chemistry after sealer placement. METHODOLOGY: Two irrigation protocols - Protocol A using 2% NaOCl used 5 mL/5 min and Protocol B with 2% NaOCl (5 mL/5 min) followed by 17% EDTA (5 mL/3 min) - were used to prepare dentine. The chemical and microstructural changes following irrigation were assessed by scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS) and Fourier transform infrared (FT-IR) spectroscopy (n = 5) on dentine obtained from the mid-root and coronal parts of extracted human teeth. Four sealers (AH Plus, BioRoot, MTA Fillapex, TotalFill) were characterized by SEM/EDS (n = 3). The ability of the sealers to eradicate intratubular Enterococcus faecalis biofilms was assessed by live/dead dye and confocal laser scanning microscopy to measure the percentage of living cells. The effect of combined irrigation and root filling on dentine was assessed by SEM and EDS analysis (n = 5). Statistical analysis was undertaken using one-way anova and a number of post hoc tests to detect intergroup differences. The F-test was used for comparison of variances in the microbiology testing. RESULTS: The use of NaOCl alone left the smear layer intact, with traces of chlorine remaining on dentine. The use of BioRoot sealer restored the calcium levels of dentine which had been depleted by the irrigation with EDTA. BioRoot exhibited antimicrobial properties against intratubular bacteria even in the presence of smear layer (Protocol A). Smear layer removal improved the bactericidal effect of all sealers and Ca2+ leaching. The use of a chelating agent was important for the intratubular sealer penetration for AH Plus but not the other sealers. CONCLUSION: The removal of smear layer was necessary for penetration of AH Plus into the dentinal tubules. BioRoot was a more effective sealer in reducing the bacterial load in the dentinal tubules than the other materials tested and the presence of smear layer did not affect its activity.

Comparative Evaluation of Root Reinforcement Using MTA-based, Epoxy Resin-based, and Silicone-based Endodontic Sealers in Canals Instrumented with Single-file Rotary System: An In Vitro Study.

AIM: To evaluate root reinforcement by four different sealers, namely, AH Plus, MTA Fillapex, Dia-ProSeal, and GuttaFlow 2, on endodontically treated teeth. MATERIALS AND METHODS: Sixty human mandibular premolars were randomly divided into four groups of 15 teeth each, according to the type of sealer used: Group I AH Plus, Group II MTA Fillapex, Group III Dia-ProSeal, and Group IV GuttaFlow 2. All samples were decoronated to a length of 13 mm from the apex. Root canals were prepared by OneShape, 25/0.06 taper file and obturated with a matching single cone gutta percha (25/0.06) using the above-mentioned sealers. All samples were subjected to load by universal testing machine until a point at which root fractured, which was recorded. RESULTS: Teeth obturated with GuttaFlow 2 showed the maximum fracture resistance followed by AH Plus, Dia-ProSeal, and MTA Fillapex. There was no significant difference in fracture resistance between AH Plus and Dia-ProSeal. CONCLUSION: Teeth obturated with GuttaFlow 2 sealer, which has powdered gutta percha particles, showed the highest fracture resistance. CLINICAL SIGNIFICANCE: According to the results obtained from this study, obturation of roots with GuttaFlow 2 increased the resistance of root canal-filled teeth to vertical root fracture.

Comparison of dentin penetration ability of different root canal sealers used with different obturation methods.

This in vitro study aimed to investigate the tubular penetration depth of four different sealers used with two different obturation methods in the apical, middle, and coronal root canal dentin. Eighty-four single-rooted teeth were instrumented until the F4 ProTaper universal rotary file and filled with AH26, AH Plus (Dentsply, DeTrey, Konstanz, Germany), RealSeal (SybronEndo, Orange, CA), and MTA Fillapex (Angelus, Londrina, Brazil) using cold lateral condensation (CLC) and single-cone (SC) obturation techniques. Thereafter, the roots were sectioned longitudinal and prepared for scanning electron microscope evaluation. The maximum and minimum sealers penetration depth into dentinal tubules at the apical, middle, and coronal regions and the average depth of sealer penetration were calculated. The data was statistically analyzed two-way ANOVA and post hoc Tukey and Dunnett tests and independent samples t test using maximum mean values. There was no statistically difference between the obturation methods (p > .05). When the sealers are evaluated within themselves AH26 was affected by obturation methods significantly (p < .05). Also the results revealed a significant difference between root regions (p < .05). AH26 and RealSeal root canal sealers had the highest penetration values with CLC and SC obturation techniques, respectively. The obturation method did not affect the penetration amount of root canal sealers. RealSeal root canal sealer performed better penetration ability than the other sealers. Apical third of the root in all groups showed lowest penetration depth.

Comparative Evaluation of Antifungal Efficacy of Five Root Canal Sealers against Clinical Isolates of Candida albicans: A Microbiological Study.

AIM AND OBJECTIVE: The aim of this study was to evaluate and compare the antifungal efficacy of MTA Fillapex, Metapex, zinc oxide eugenol cement, Endomethasone, and Endoflas against Candida albicans. MATERIALS AND METHODS: Root canal exudates of 30 patients were tested against MTA Fillapex (Angelus), Metapex (BioMed), zinc oxide eugenol (Deepak Enterprise), Endomethasone (Septodont), Endoflas FS (Sanlor Laboratories), MTA (Angelus) (positive control), and glycerine (negative control). Children with failed endodontic cases were included in the study. Tube dilution and agar diffusion methods were used to check the antifungal efficacy of the root canal sealers. In tube dilution method, 24-well culture plates containing freshly mixed material along with Candida albicans were used. Wells containing MTA (Angelus) along with Sabouraud dextrose agar and Candida albicans served as positive control while glycerine along with Sabouraud dextrose agar and Candida albicans served as negative control. All plates were incubated at 37°C for 24 hours. Growth of the fungi was monitored after 24 hours by the presence of the turbidity. The samples were recultured to test the experimental material using agar well diffusion method, and the Petri plates were incubated for 24 hours and 72 hours. Zone of inhibition was measured after respective time period. Paired t test was used for the data analysis. RESULTS: It was seen in tube dilution method Endomethasone showed least turbidity while maximum was shown by Metapex; similar results were seen in case of agar well diffusion method in which largest zone of inhibition was shown by Endomethasone while smallest was by Metapex. CONCLUSION: It was concluded that Endomethasone showed maximum efficacy against Candida albicans as compared to Metapex. HOW TO CITE THIS ARTICLE: Singh S, Srivastava B, Gupta K, et al. Comparative Evaluation of Antifungal Efficacy of Five Root Canal Sealers against Clinical Isolates of Candida albicans: A Microbiological Study. Int J Clin Pediatr Dent 2020;13(2):119-123.

Successful Use of MTA Fillapex as a Sealant for Feline Root Canal Therapy of 50 Canines in 37 Cats.

Intentional or unintentional pulp exposure of cat canines can lead to periapical disease, osteomyelitis, and oral pain. Root canal therapy (RCT) allows the retention of cat canines with pulp exposure by removing the infected pulp and replacing it with an inert material. This study used MTA Fillapex™ as a root canal sealant with gutta percha single cone obturation in 37 cats (50 canine teeth). Roots were classified as "successful," "no evidence of failure (NEF)," or "failed" at 6-month radiographic reviews. Therapy was considered "successful" if a preoperative periapical lucency had healed or not formed after treatment and any preoperative external inflammatory root resorption (EIRR) had stabilized without progression. Therapy was categorized as "NEF" if a periapical lucency had remained the same or decreased in size but not completely resolved and any preoperative EIRR had stabilized without progression. "Failed" if a periapical lucency had occurred or increased in size posttreatment or if EIRR had developed or progressed posttreatment. Thirty-two canine teeth (64%) were classified as "successful," 14 canine teeth (28%) were classified as "NEF," and 4 canine teeth (8%) were classified as "failed". The study concluded that RCT using MTA Fillapex as a root canal sealant is a suitable endodontic treatment for fractured cat canines, especially those that are periodontally or endodontically challenged.

Fracture Resistance of Endodontically Treated Teeth Obturated with Different Root Canal Sealers (A Comparative Study).

AIM: The aim of this study is to compare the effect of different root canal sealers on the fracture resistance of endodontically treated teeth using AH Plus, GuttaFlow 2, MTA-Fillapex, and TotalFill® BC™ sealers. MATERIALS AND METHODS: Sixty single-rooted mandibular premolar teeth were used in the study. After the decoronation of the crowns of the teeth, we got a 13 mm root length. All samples instrumented using ProTaper Next system reaching file size ×4 as the final master apical file. Gutta-percha (GP) with single cone as obturation technique was carried out to all experimental teeth. Then, the teeth were divided into five groups (n = 12) based on the type of sealer to be used. Group I: AH Plus sealer + GP, Group II: GuttaFlow 2 sealer + GP, Group III: MTA-Fillapex sealer + GP, Group IV: TotalFill BC sealer + GP, and Group V: control (instrumented but unobturated teeth). Embedding all teeth in acrylic resin blocks was carried out and fracture force was measured using a universal testing machine (Instron Corp., Canton, MA, USA) by using metal-like spreader tip on 0.5 mm/m speed. Then, the data were statistically evaluated using one-way analysis of variance (ANOVA) and post hoc test (Tukey's test). RESULTS: Group IV showed higher resistance to fracture than other groups significantly. There was a nonsignificant difference in fracture force between Group I, Group II, and Group III. Group V showed the least fracture resistance than other groups. CONCLUSION: Based on this in vitro study, TotalFill bioceramic-based sealer was more effective when compared with other sealers and the unobturated group showed the lowest mean fracture resistance. CLINICAL SIGNIFICANCE: The use of bioceramic sealer with BC cones enhanced the fracture resistance of endodontically treated teeth.

Dentin moisture conditions strongly influence its interactions with bioactive root canal sealers.

OBJECTIVES: It is known that bioactive materials interact with the dentin to undergo biomineralization. The exact role of moisture in this interaction is unknown. Here, we investigate the effects of dentin moisture conditions on the dislocation resistance of two bioactive root canal sealers (MTA Fillapex [Angelus Solucoes Odontologicas] and GuttaFlow BioSeal [Colténe/Whaledent AG]) at 3 weeks and 3 months after obturation. MATERIALS AND METHODS: Mandibular premolars (n = 120) were prepared and randomly divided into 3 groups based on the dentin condition: group 1, dry dentin; group 2, moist dentin; group 3, wet dentin. Each group was divided into 2 subgroups for root canal filling: MTA Fillapex and GuttaFlow BioSeal. Dislocation resistance was evaluated by measuring the push-out bond strength at 3 weeks and 3 months. Failure modes were examined under a stereomicroscope. Data were statistically analyzed by Kruskal-Wallis test with a significance level of 5%. RESULTS: Moist dentin resulted in higher bond strength values for both materials at both time points. This was significantly higher than wet and dry dentin for both the sealers at the 3 months (p < 0.05), while at 3 weeks it was significant only for GuttaFlow Bioseal. The different moisture conditions demonstrated similar trends in their effects on the dislocation resistance of the 2 root canal sealers. CONCLUSIONS: The dentin moisture conditions had a significant impact on its interaction with the bioactive materials tested. Maintaining moist dentin, but not dry or wet dentin, may be advantageous before the filling root canals with bioactive sealers.

Evaluation of Sealing Ability of Three Root Canal Sealers: An In Vitro Study.

AIM: To evaluate the sealing ability of three different types of sealers using confocal laser microscopy. MATERIALS AND METHODS: Sixty extracted single-root premolars were selected and divided into three groups (20 teeth in each group) according to the type of sealer used, namely, mineral trioxide aggregate (MTA) Fillapex, AH Plus, and Bio C Sealer. Root canal preparation and obturation were done in all the samples. Roots was dissected transversely in apical plane. Percentage of gap from region to canal circumference was calculated using a confocal laser microscope. Samples were subjected to statistical analysis. RESULTS: High dye penetration was seen with AH Plus compared to MTA Fillapex and least with Bio C Sealer. The AH Plus is the best sealer with respect to seal ability of all the three. CONCLUSION: This study helps to appraise the sealing ability of the different types of sealers using confocal laser microscopy which is useful for the success of root canal treatment. CLINICAL SIGNIFICANCE: As sealer has to seal voids, foramina, and canals, it should have good penetration for the success of root canal treatment.

Evaluation of the apical microleakage of MTA Fillapex, AH26, and Endofill sealers / Avaliação da microinfiltração apical de cimentos MTA Fillapex, AH26 e Endofill

Objective: Proper apical seal plays an important role in the success of root canal treatment. The most common cause of failure of root canal therapy is known as the lack of adequate apical seal. The aim of this in vitro study was to compare the apical microleakage of MTA Fillapex, AH26, and Endofill sealers using dye penetration method. Material and Methods: In this in vitro study, 72 single-rooted extracted human teeth were selected. The teeth were randomly divided into three experimental groups of 20 and two positive and negative control groups of 6. The canals were prepared by step-back technique and then filled with gutta-percha and one of the sealers mentioned. In the positive control group, the canals were filled with gutta-percha without sealer, and in the negative control group, the canals were prepared but not filled. The teeth were immersed in 2% methylene blue dye for 72 hours. The teeth were then cut longitudinally and the level of dye penetration was measured under a stereomicroscope. Data were analyzed by SPSS ver. 19 software, ANOVA and Bonferroni post-hoc tests. Results: The mean level of dye penetration in the Endofill test group was significantly higher than that in the AH26 and MTA Fillapex test groups. While, the observed difference between AH26 and MTA Fillapex groups was not statistically significant (p<0.05). Conclusion: The results of this study showed that AH26 and MTA Fillapex sealers did not show any significant difference in apical seal properties. However, their sealing strength was significantly greater than Endofill sealer. (AU)

Objetivo: O selamento apical adequado desempenha um papel importante no sucesso do tratamento do canal radicular. A causa mais comum de falha da terapia endodôntica é conhecida como falta de selamento apical adequado. O objetivo deste estudo in vitro foi comparar a microinfiltração apical dos cimentos MTA Fillapex, AH26 e Endofill usando o método de penetração de corantes. Materiais e métodos: Neste estudo in vitro, 72 dentes humanos unirradiculares extraídos foram selecionados. Os dentes foram divididos aleatoriamente em três grupos experimentais de 20 e dois grupos controle, positivo e negative, de 6. Os canais foram preparados pela técnica escalonada e preenchidos com guta-percha e um dos cimentos mencionados. No grupo controle positivo, os canais foram preenchidos com guta-percha sem cimento, e no grupo controle negativo, os canais foram preparados, mas não preenchidos. Os dentes foram imersos em corante azul de metileno a 2% por 72 horas. Os dentes foram então cortados longitudinalmente e o nível de penetração do corante foi medido sob um estereomicroscópio. Os dados foram analisados pelo software SPSS ver. 19 e pelos testes ANOVA e post-hoc de Bonferroni. Resultados: O nível médio de penetração do corante no grupo de teste Endofill foi significativamente maior do que nos grupos de teste AH26 e MTA Fillapex. Enquanto, a diferença observada entre os grupos AH26 e MTA Fillapex não foi estatisticamente significante (p <0,05). Conclusão: Os resultados deste estudo mostraram que os cimentos AH26 e MTA Fillapex não apresentaram diferença significativa nas propriedades do selamento apical. No entanto, suas forças de vedação foram significativamente maiores que a do cimento Endofill. (AU)

Effect of Different Irrigation Solutions on the Apical Sealing Ability of Different Single-cone Obturation Systems: An In Vitro Study.

AIM: The aim of this study was to assess the effect of three root canal irrigants on the apical sealing ability of three single-cone obturation systems. MATERIALS AND METHODS: One hundred maxillary central incisors were selected and their crowns were cut. The roots were divided into three experimental groups of 30 samples each, and one control group of 10 samples (5 positives and 5 negatives). Each experimental group was divided equally into three subgroups according to the obturation system. All root canals were instrumented using ProTaper Universal rotary system and irrigated with 3% sodium hypochlorite (Group 1), 2% chlorohexidine (Group 2), 3% hydrogen peroxide (Group 3). Finally, root canals were irrigated with 17% EDTA followed by distilled water, then obturated with a single-cone technique using gutta-percha/MTA Fillapex (Subgroup A), gutta-percha/ AH Plus (Subgroup B), and Resilon/Relseal SE (Subgroup C). The microleakage was assessed using linear dye penetration method and data were statistically analyzed. RESULTS: Significant differences were found between all groups and subgroups (p < 0.005). When 3% of hydrogen peroxide was used, no leakage was observed with AH Plus sealer, and a high amount of leakage (5.82 ± 0.47 mm) was observed with Realseal SE. MTA Fillapex (0.49 ± 0.08 mm) and Realseal SE (1.11 ± 0.50 mm) showed the lowest amounts of leakage when 2% chlorohexidine and 3% sodium hypochlorite were used, respectively. CONCLUSION: The type of irrigating solution and obturation system could affect the apical leakage value when single-cone obturation technique was used. AH Plus/gutta-percha obturation system showed no apical leakage when root canals were irrigated with 3% hydrogen peroxide. The using of 2% chlorohexidine improved sealing ability of MTA Fillapex/gutta-percha. The apical sealing ability of Realseal SE/Resilon decreased when 3% hydrogen peroxide or 2% chlorhexidine was used. CLINICAL SIGNIFICANCE: Proper selection of irrigating solutions may positively influence the apical sealing ability of single-cone obturation systems.