Effect of Different Sealers on the Cytocompatibility and Osteogenic Potential of Human Periodontal Ligament Stem Cells: An In Vitro Study.

BACKGROUND: There is tendency for unavoidable sealer extrusion in some clinical cases. This might adversely affect host stem cells and affect healing. This study aimed to investigate the effect of different sealers on the cytocompatibility and osteogenic potential of human periodontal ligament stem cells (hPDLSCs). METHODS: The cytotoxic effect of the extracted elutes of VDW.1Seal (VDW.1), Endosequence BC Sealer HiFlow (ES), GuttaFlow-2 (GF), and ADSeal (AD-S) on the hPDLSCs was determined using the MTT assay. Cell proliferation and migration were assessed by the scratch wound healing assay. Osteogenic differentiation potential was assessed. Measurement of pH values and calcium ions release was performed. RESULTS: GF had a significantly higher percentage of viable cells. The cell migration assay showed that GF demonstrated the lowest open wound area percentage. GF and AD-S showed the highest calcium nodule deposition. GF demonstrated higher ALP activity than ES. Expression of RUNX2 and OC genes was similar for all sealers, while OPG gene expression was significantly higher for VDW.1 and GF. ES and AD-S displayed the highest pH values on day 1. Calcium ion release of ES and VDW.1 was significantly the highest. CONCLUSIONS: GuttaFlow-2 and VDW.1Seal sealers have favorable behavior toward host stem cells.

The Influence of the Matrix on the Apatite-Forming Ability of Calcium Containing Polydimethylsiloxane-Based Cements for Endodontics.

This study aimed to characterize the chemical properties and bioactivity of an endodontic sealer (GuttaFlow Bioseal) based on polydimethylsiloxane (PDMS) and containing a calcium bioglass as a doping agent. Commercial PDMS-based cement free from calcium bioglass (GuttaFlow 2 and RoekoSeal) were characterized for comparison as well as GuttaFlow 2 doped with dicalcium phosphate dihydrate, hydroxyapatite, or a tricalcium silicate-based cement. IR and Raman analyses were performed on fresh materials as well as after aging tests in Hank's Balanced Salt Solution (28 d, 37 °C). Under these conditions, the strengthening of the 970 cm−1 Raman band and the appearance of the IR components at 1455−1414, 1015, 868, and 600−559 cm−1 revealed the deposition of B-type carbonated apatite. The Raman I970/I638 and IR A1010/A1258 ratios (markers of apatite-forming ability) showed that bioactivity decreased along with the series: GuttaFlow Bioseal > GuttaFlow 2 > RoekoSeal. The PDMS matrix played a relevant role in bioactivity; in GuttaFlow 2, the crosslinking degree was favorable for Ca2+ adsorption/complexation and the formation of a thin calcium phosphate layer. In the less crosslinked RoekoSeal, such processes did not occur. The doped cements showed bioactivity higher than GuttaFlow 2, suggesting that the particles of the mineralizing agents are spontaneously exposed on the cement surface, although the hydrophobicity of the PDMS matrix slowed down apatite deposition. Relevant properties in the endodontic practice (i.e., setting time, radiopacity, apatite-forming ability) were related to material composition and the crosslinking degree.

Postoperative pain intensity and incidence following single visit root canal treatment with different obturation techniques: a randomized clinical trial.

Background: There are few studies in the literature about the effect of obturation techniques on postoperative pain. Besides, GuttaFlow2 was used for the first time in this study regarding postoperative pain. This study aimed to compare the postoperative pain levels and incidence following single-visit root canal treatment with different canal filling techniques; cold lateral compaction (CLC), thermoplasticised solid-core carrier (GuttaCore) based filling and cold free-flow compaction (GuttaFlow2) technique. Methods: The patients (n = 93) having single-rooted teeth with a single canal diagnosed with asymptomatic irreversible pulpitis or single-rooted vital teeth with a single canal requiring endodontic treatment because of prosthetic reasons were enrolled in this study. Patients were randomized into three groups (n = 31) according to the obturation technique. A single operator performed all the treatments in a single visit. Data on obturation levels, postoperative pain and analgesic intake frequency were recorded at postoperative 6, 12 and 24 h and daily afterward until the 7th day. Postoperative pain was measured by visual analogue scale (VAS). The date were statistically analyzed with chi-squared tests (for the analyses of the categorical data), the nonparametric Kruskal-Wallis test (for the comparisons of VAS score) and with the Friedman test (for the assessments of the changes in VAS scores over time). Results: The GuttaCore group recorded the higher pain levels, except first 12 h, on the other hand, the GuttaFlow2 group recorded the lower pain levels at all time periods. Significant differences occurred among the groups during the first 4 days (p < 0.05), except at 12 h (p = 0.054). The patients in the CLC and GuttaFlow2 groups did not need to use the prescribed analgesic; however, one patient in the GuttaCore group used it once. Conclusions: Postoperative pain levels following root canal therapy were affected by the obturation technique especially first 4 days following obturation.

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.

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.

Comparison of clinical application of iRoot SP, GuttaFlow 2 and AH Plus root canal sealer / 口腔疾病防治

Objective@# The short-term clinical effects of two kinds of normal temperature flow root sealers (the calcium silicate-based sealer iRoot SP and the siloxane-based sealer GuttaFlow2) combined with single point filling technology and a frequently-used sealing agent (AH Plus) combined with continuous wave hot tooth filling technology were evaluated. @*Methods @#A total of 279 teeth (656 root canals) were randomly divided into three groups: the iRoot SP group, GuttaFlow2 group and AH plus group. We recorded the filling time of each root canal, collected a digital dental film to evaluate the filling effect of each root canal, and conducted a follow-up visit one week and one month after the operation to record the incidence of pain. We used SPSS 18.0 to analyze the above data. @*Results @# There was no significant difference in the root canal filling effect among the three groups (P > 0.05). There was no significant difference in the filling time between the iRoot SP group and the GuttaFlow2 group (P > 0.05), but the filling time was significantly shorter in the AH Plus group (P < 0.05). There was no significant difference in the postoperative pain between the iRoot SP group and the GuttaFlow2 group (P > 0.05), and the incidence of pain in the iRoot SP group and the GuttaFlow2 group was lower than that in the AH Plus group (P < 0.05).@*Conclusions @# GuttaFlow2 and iRoot SP combined with single point filling technology can save filling time and obtain good clinical effects compared with frequently-used hot tooth filling technology and the incidence of postoperative pain was low.

The push out bond strength of polydimethylsiloxane endodontic sealers to dentin.

BACKGROUND: The purpose of this experiment was to assess the push out bond strength of Polydimethylsiloxane sealers (GuttaFlow 2 and GuttaFlow Bioseal by Colte'ne/Whaledent, Altstätten, Switzerland). AH Plus (Dentsply, DeTrey, Konstanz, Germany) was used as a reference material for comparison. METHODS: Thirty root slices were prepared from the middle third of 10 mandibular premolars. Each slice was 1 ± 0.1 mm thick. Three holes, 0.8 mm wide each, were drilled on the axial side of each root slice. These holes were subjected to standardized irrigations and then dried using paper points. Finally, for each root slice, each hole was filled with exactly one of the following three root canal sealers: AH Plus, GuttaFlow 2 and GuttaFlow Bioseal. After all the holes were filled in that way, the root slices were stored on top of phosphate-buffered saline solution (pH 7.2) soaked gauze for 7 days at the temperature of 37 degrees Celsius. Then, for each root canal sealer on a root slice, the universal testing machine was used to measure the push out bond strength. The differences in push out bond strengths between the three sealer samples were assessed using the Friedman test, while the paired comparisons were assessed using Wilcoxon signed rank test with Bonferroni correction. All statistical tests were two-tailed and the significance level was set at the 5%. RESULTS: According to the Friedman test the distributions of push out bond strengths of AH Plus, GuttaFlow 2 and GuttaFlow Bioseal were different (P < 0.05). Paired comparisons indicated that AH Plus had a significantly superior push out bond strength than GuttaFlow 2 and GuttaFlow Bioseal, while the push out bond strength of GuttaFlow Bioseal was significantly stronger than that of GuttaFlow 2 (P < 0.01). CONCLUSIONS: Based on these findings, AH Plus is a better root canal sealer than GuttaFlow 2 and GuttaFlow Bioseal.

Dentinal Adaptation of Warm Thermoplastic Obturating Material and Cold Thermoplastic Obturating Material: An In vitro Study.

INTRODUCTION: The objective of endodontic obturation is to provide a complete seal along the length of the root canal system, thereby ensuring the healing and sustained health of the periradicular tissue. Root canal obturation involves the three-dimensional filling of the entire root canal system and is a critical step in endodontic therapy. Gutta-percha has universally been accepted as the gold standard for root canal filling materials. However, it lacks bonding to the internal tooth structure resulting in the absence of complete seal. AIM: The aim of the present study is to compare the dentinal adaptation of warm thermoplastic obturating material and cold thermoplastic obturating materials. MATERIALS AND METHODS: Thirty single-rooted, anterior noncarious human teeth extracted for periodontal or orthodontic reasons were used for the study. The samples were stored in distilled water until obturation. The specimens were then randomly divided into three groups of ten specimens each: Control group - Cold lateral condensation with AH Plus, Group I - Endosure with AH Plus®, and Group II - GuttaFlow® 2 with master cone. The obturation for each group was done following manufacturer's instructions. Under On-demand software, the area of voids at the level of 3 mm, 5 mm, and 8 mm from the apex was observed for all the samples. The obtained results were submitted for statistical analysis. RESULTS: The result in the present study showed that Endosure provides a better consistent seal as compared to cold lateral condensation, or GuttaFlow 2 techniques. CONCLUSION: Mean void value was maximum for GuttaFlow 2 group, followed by cold lateral condensation, Endosure. Though there was a difference in the mean void values, it was not statistically significant except between Endosure and GuttaFlow 2. The result in the present study showed that Endosure provides a better seal as compared to cold lateral compaction, GuttaFlow 2 or Endosure technique.

Comparing the Ability of Different Materials and Techniques in Filling Artificial Internal Resorption Cavities.

OBJECTIVE: This ex vivo study aims to investigate the root filling quality of warm vertical technique, single-cone technique with GuttaFlow2, Endoseal MTA and EndoSequence BC sealer as a sealer in artificial internal resorption cavity. METHODS: For this study, 40 human single-root teeth were selected. After root preparation, the roots were horizontally sectioned 7 mm from the apex. The hemisphere cavities were created on both sides, and then they were re-approximated. According to filling methods and materials, the samples were randomly as-signed to four experimental groups: I: warm vertical compaction technique (WVC), II: single-cone technique with GuttaFlow2 (GF), III: single-cone technique with Endoseal MTA sealer (EM), IV: single-cone technique with EndoSequence BC sealer (ES). Filled roots were radiographed in buccolingual and mesiodistal views to check the obturation, and stored in humid environment at the room temperature for 7 days. Each tooth was sectioned 7 mm from the root apex at the level of the previous cut, and it was then photographed un-der stereomicroscope. The photographs and radiographs of all samples were imported to an image-analysis software to calculate the percentage of sealer, gutta-percha, and voids. The results were statistically analyzed using one-way ANOVA and Kruskal-Wallis Dunn's tests. RESULTS: In buccolingual view of radiographs, the WVC and EM groups showed significantly lower percent-age of voids (P value<0.05) compared to that in the GF group. In mesiodistal view, the WVC and EM groups showed significantly lower percentage of voids (P value<0.05) compared to that in the GF and ES groups. In stereomicroscope evaluation, the WVC and EM groups showed significantly lower percentage of voids (P value<0.05) compared to that in the GF and ES groups. The differences observed between the WVC and EM groups (P value>0.05) or between the GF and ES groups (P value>0.05) were not significant. CONCLUSION: WVC technique and single-cone technique with EM sealer are the optimum methods to fill ar-tificial resorption cavities.

Influence of the final irrigation solution on the push-out bond strength of calcium silicate-based, epoxy resin-based and silicone-based endodontic sealers.

The aim was to evaluate the influence of different irrigation solutions on the push-out bond strength (POBS) of three different sealers (AH Plus, BioRoot RCS, GuttaFlow2). Root canals of 180 single-rooted human teeth were instrumented with F360 up to size 45.04. All canals were irrigated with 5 ml NaOCl 3% and 5 ml EDTA 17%. The canals were finally irrigated with either 5 ml NaOCl 3%, CHX 2%, EDTA 17%, citric acid 20% or NaCl 0.9% (n = 36) with a contact time of 5 min and obturated using matching gutta-percha cones according to the single-cone technique in combination with one of the sealers (n = 12). After 8 weeks of incubation, the roots were embedded in resin. Two slices of 1 mm thickness were obtained representing the middle third of the root. Dislodgement resistance was measured and POBS was calculated. Specimens were examined under 4× magnification to determine the mode of bond failure. Statistical analysis was performed using two-way ANOVA and Student-Newman-Keuls test for POBS and Chi-square test for the mode of failure. POBS was significantly affected by the factor "sealer" (P < 0.001) and by the interaction "sealer/irrigation solution" (P < 0.01). AH Plus revealed significantly higher POBS than BioRoot RCS and GuttaFlow2 (P < 0.05). The POBS of GutttaFlow2 was not affected by the irrigation protocol (P > 0.05). The POBS of AH Plus was positively influenced by EDTA and NaOCl. EDTA had a negative effect on the POBS of BioRoot RCS. The POBS of GuttaFlow2 was not influenced by the irrigation solutions.

Novel endodontic sealers induced satisfactory tissue response in mice.

OBJECTIVES: The aim of this study was to evaluate the subcutaneous response induced by Roeko Guttaflow2 (RG), Sealapex Xpress (SX), AH Plus (AHP) sealers. METHODS: 100 BALB/c mice received implants in the subcutaneous tissue with the tested materials (10 animals per period for each evaluated sealer) and were evaluated after different experimental periods (7, 21 and 63 days), in each animal was placed a tube, the control group was an empty tube. Histological analysis evaluated semi-quantitatively the inflammatory infiltration, collagen fiber formation and tissue thickness. In addition, immunohistochemistry was performed for interleukin-6 (IL-6). Data were statistically analyzed (α = 0.05). RESULTS: RG promoted a greater collagen fiber formation at 7 days and 63 days compared to the CG (p = 0.004) and AHP (p = 0.005) respectively, while at 21 days, the SX promoted a greater reaction (p = 0.021). For the tissue thickness, there was a greater reaction at 7 days with CG (p = 0.0156) and with RG at 63 days (p = 0.03). Regarding the inflammatory infiltrate, there was no difference at 7 days and 63 days (p = 0.5; p = 0.27), while at 21 days, a statistically difference was found between SX, CG (p = 0.04) and RG (p = 0.027). In addition, the presence of IL-6 was observed in almost all groups, with a more intense marking at 7days. SIGNIFICANCE: All cements evaluated presented a satisfactory tissue response, however, RG was the one that presented a more satisfactory tissue response.

In Vitro Cytotoxicity of GuttaFlow Bioseal, GuttaFlow 2, AH-Plus and MTA Fillapex.

INTRODUCTION: The aim of the present in vitro study was to evaluate the cytotoxicity of different sealers including GuttaFlow Bioseal, GuttaFlow 2, AH-Plus and MTA Fillapex on L929 murine fibroblasts. METHODS AND MATERIALS: Samples of GuttaFlow Bioseal, GuttaFlow 2, AH-Plus and MTA Fillapex were fabricated in Teflon disks of 5 mm diameter and 3 mm thickness. L929 fibroblasts were exposed to the extracts of these materials for 3, 24, 72 and 168 h at 37°C with 5% CO2. Cell viability was evaluated by the 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. Apoptosis was evaluated by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay. The data were analysed by ANOVA. RESULTS: GuttaFlow Bioseal was nontoxic at all experimental time points (P>0.05), whereas MTA Fillapex and AH-Plus were toxic (P<0.001). At 7 days, there were more viable cells in the GuttaFlow 2 group than in the control group, and MTA Fillapex was more cytotoxic than AH-Plus. There were more apoptotic cells in the MTA Fillapex and AH-Plus groups than in the other groups at 3 h (P<0.001). CONCLUSION: GuttaFlow sealers are less cytotoxic than MTA Fillapex and AH-Plus. At all experimental time points, there was no significant difference in the cell viability between the GuttaFlow Bioseal group and the control group.

Microgap Evaluation of Novel Hydrophilic and Hydrophobic Obturating System: A Scanning Electron Microscope Study.

INTRODUCTION: The purpose of an endodontic obturation is to obtain a fluid tight hermetic seal of the entire root canal system. There has been an evolution of different materials and techniques to achieve this desired gap free fluid tight seal due to presence of anatomic complexity of the root canal system. AIM: To compare the microgap occurring in root canals obturated with hydrophilic versus hydrophobic systems using scanning electron microscope. MATERIALS AND METHODS: Sixty extracted human single-rooted premolars were decoronated, instrumented using NiTi rotary instruments. The samples (n=20) were divided into three groups and obturated with Group A - (control group) gutta-percha with AH Plus, Group B - C-point with Smartpaste Bio and Group C - gutta-percha with guttaflow 2. The samples were split longitudinally into two halves and microgap was observed under scanning electron microscope in the apical 3 mm of the root canal. RESULTS: Group A (control) showed a mean difference of 8.54 as compared to 5.76 in group C. Group B showed the lowest mean difference of 0.83 suggesting that the hydrophilic system (C-point/Smartpaste Bio) produced least microgap as compared to the hydrophobic groups. CONCLUSION: Novel hydrophilic obturating system (C-points/ Smart-paste Bio) showed better seal and least microgap as compared to gutta-percha/guttaflow 2 and gutta-percha/ AH plus which showed gap at the sealer dentin interface due to less penetration and bonding of these hydrophobic obturating system.

Comparative evaluation of fracture resistance of root canals obturated with four different obturating systems.

AIM AND OBJECTIVES: The aim of this study is to evaluate and compare the fracture resistance of root canals obturated with four different obturating systems in endodontically treated teeth. MATERIALS AND METHODS: One hundred and twenty single-rooted teeth were selected and decoronated at cementoenamel junction. Instrumentation of teeth (except control group) was done with Mtwo rotary files up to size 25/0.06 using a step-back technique. All teeth were divided into four experimental groups (n = 25) and two control groups (n = 10). In Group I (negative control), teeth were neither instrumented nor obturated, in Group II (positive control), instrumentation was done, but no obturation was performed, in Group III, obturation was done with cold lateral compaction technique, in Group IV, obturation was done with cold free-flow compaction technique, in Group V, obturation was done with warm vertical compaction technique, and in Group VI, obturation was done with injection-molded thermoplasticized technique. All prepared teeth were embedded in an acrylic resin block, and their fracture strength was measured using Universal Testing Machine. Statistical data were analyzed using one-way analysis of variance and Tukey's honestly significant difference test. RESULTS: Negative control Group I showed highest fracture resistance and positive control Group II had lowest fracture resistance. Among experimental groups, cold free-flow compaction technique with GuttaFlow2 (Group IV) showed higher fracture resistance as compared to the Group III, Group V, and Group VI. CONCLUSION: GuttaFlow2 has the potential to strengthen the endodontically treated roots to a level that is similar to that of intact teeth.

Biological Tissue Response to a New Formulation of a Silicone Based Endodontic Sealer

Abstract Satisfactory biological behavior is a necessary requirement for clinical application of endodontic materials. In this study, the connective tissue responses to silicone (GuttaFlow 2), epoxy resin (AH Plus) and zinc oxide and eugenol (Endofill) based sealers were compared. Twelve Wistar rats had polyethylene tubes (four per animal) containing one of the tested sealers and empty tubes (negative control) implanted in their subcutaneous tissue. The tubes were randomly placed 2 cm from the spine and at least 2 cm apart from one another. Tissue samples with implants were processed for histological analysis after 7 or 60 days (n=6 animals per period). Inflammatory cells, fibrous condensation and abscess were scored according to their intensity. Friedman, followed by Dunn's post hoc, was used to compare sealers. Differences between the two experimental periods were verified using Mann-Witney U test (p<0.05). At 7 days, most of the histological parameters showed no significant differences amongst groups. Endofill group scored higher than the others for giant cells (o<0.05) and promoted a greater number of samples presenting abscess formation. GuttaFlow 2 tended to show a less intense inflammatory infiltrate compared to the other materials. At 60 days, there were no significant differences between groups in most of the histological parameters evaluated. However, it was observed that Endofill scored higher for macrophages (p<0.05) compared to the control group, and GuttaFlow 2 tended to present lower scores than the others for neutrophils and abscess. GuttaFlow 2 showed proper biological behavior and should be considered adequate for clinical practice.

Resumo Um dos requisistos para a aplicação clínica de materiais endodônticos é apresentar comportamento biológico satisfatório. Neste estudo, as respostas do tecido conjuntivo a cimentos endodônticos à base de silicone (GuttaFlow 2), resina epóxica (AH Plus) e óxido de zinco e eugenol (Endofill) foram comparadas. Doze ratos Wistar tiveram tubos de polietileno (4 em cada animal) contendo um dos materiais e tubos vazios (controle negativo) implantados no tecido conjuntivo subcutâneo. Os tubos foram randomicamente posicionados pelo menos 2 cm distantes entre si e da espinha dorsal do animal. Amostras de tecido contendo os implantes foram processadas para análise histológica após 7 e 60 dias (n=6 animais por período). Células inflamatórias, condensação fibrosa e formação de abscesso foram classificadas em escores de acordo com sua intensidade. O teste Friedman, seguido por post hoc de Dunn, foi empregado para comparar os cimentos. O teste de Mann-Witney U foi empregado para verificar diferenças entre os períodos experimentais em cada grupo (p<0,05). Após 7 dias, a maior parte dos parâmetros histológicos não mostrou diferenças estatísticas entre os grupos. O cimento Endofill promoveu escores mais altos que os outros materiais para a variável células gigantes (p<0,05), além de apresentar um maior número de amostras com formação de abscesso. O GuttaFlow 2 tendeu a apresentar infiltrado inflamatório menos intenso comparado aos outros materiais. Após 60 dias, não houve diferenças estatisticamente significantes entre os grupos na maioria dos parâmetros avaliados. Entretanto, observou-se que o EndoFill apresentou escores mais altos para os macrófagos em comparação ao controle (p<0,05) e que o GuttaFlow 2 apresentou tendência a escores mais baixos que os demais materiais para as variáveis neutrófilos e abscesso. O GuttaFlow 2 apresentou propriedades biológicas apropriadas e pode ser considerado adequado para a prática clínica.

An Evaluation of GuttaFlow2 in Filling Artificial Internal Resorption Cavities: An in vitro Study.

INTRODUCTION: Obturation of root canal with internal resorption represents a major challenge in Endodontics. In spite of that, usual obturation techniques are often employed without considering the best technique to solve this problem. The goal of this study was to investigate the ability of GuttaFlow2 in filling artificial internal resorption cavities. MATERIALS AND METHODS: The study sample included 36 human upper central incisors that were prepared using Protaper system (F4). Internal resorption cavities were prepared by cutting each tooth at 7 mm from the apex and preparing hemispherical cavities on both the sides and then re-attaching them. The sample was randomly separated into three groups (n = 12 in each group). In the first group, thermal injection technique (Obtura II) was employed and served as the control group. In the second group, injection of cold free-flow obturation technique with a master cone (GF2-C) was employed, whereas in the third group injection of cold free-flow obturation without a master cone (GF2) was followed. The teeth were re-cut at the same level as before and examined under a stereomicroscope. Subsequently, the captured images were transferred to AutoCAD program to measure the percentage of total filling "TF," gutta-percha "G," sealer "S," and voids "V" out of the total surface of the cross sections. RESULTS: All materials showed high filling properties in terms of "total filling," ranging from 99.17% (for Obtura II) to 99.72% (for GF2-C). Regarding gutta-percha percentages of filling, they ranged from 83.15 to 83.93%, whereas those for the sealer ranged from 5.71 to 15.24%. GuttaFlow2 group with a master cone appeared to give the best results despite the insignificant differences among the three groups. CONCLUSION: The GuttaFlow2 with a master cone technique seemed to be a promising filling material and gave results similar to those observed with Obtura II. It is recommended for use to obturate internal resorption cavities in clinical practice due to its good adaptability to root canal walls, ease of handling, and application. CLINICAL SIGNIFICANCE: Internal resorption defects can be successfully filled with GuttaFlow2 material when supplemented with a master cone, and the results are comparable with those obtained with the Obtura II technique.

Sealing ability of different versions of GuttaFlow2 in comparison to GuttaFlow and AH Plus

Introduction and objective: GuttaFlow2 is a further development of the silicone sealer GuttaFlow, exhibiting a stiffer consistency. This is intended to overcome possible problems regarding retention of the apical part of the root canal filling when preparing for a fiber post. GuttaFlow2 is delivered within a capsule, like GuttaFlow, or within an automix syringe. This study compared apical dye leakage of GuttaFlow2 in comparison to GuttaFlow and AH Plus. The null hypothesis tested was that different sealers exhibited similar microleakage. Material and methods: Seventy extracted human lower premolars with fully mature apices were root canal prepared to 45/.04 and divided into seven groups: group 1: AH Plus sealer, group 2: "normal" setting GuttaFlow, group 3: "fast" setting GuttaFlow, group 4: GuttaFlow2 within a capsule, group 5: GuttaFlow2 within an automix syringe, group 6: positive control, group 7: negative control (n = 10 each). Root canals were filled with sealer (except group 7) and a master gutta-percha cone size 40/.04 using the non-compaction technique. A dye penetration test was carried out by centrifugation for 3 min at 30 G within 5 % methylene blue dye. Linear dye penetration was recorded. Statistical evaluation was carried out with IBM SPSS 19.0 (α = 0.05). Results: The positive control was significantly different from all other groups (ANOVA, p < 0.001; Student-Newman-Keuls post-hoc test p < 0.05). When the control groups were disregarded, no significant differences were apparent. Groups 1 to 5 showed low leakage values when compared with results of earlier studies using a similar methodology. Conclusion: All sealers tested exhibited low dye leakage values.

In vitro cytotoxicity of guttaflow 2 on human gingival fibroblasts.

INTRODUCTION: The primary aim of this study was to evaluate the cytotoxic effects of GuttaFlow 2 (Coltène Whaledent, GmBH+Co KG, Langenau, Switzerland) on human gingival fibroblasts (HGFs). METHODS: Samples of the test materials GuttaFlow 2, mineral trioxide aggregate (MTA), AH Plus (Dentsply DeTrey, Konstanz, Germany), and RealSeal sealer (SybronEndo, Orange, CA) were fabricated in cylindrical nonreactive plastic tubes of 3-mm diameter and 2-mm height. Extracts of freshly mixed and set samples were prepared using the ratio of 0.5 cm(2)/mL, 1 cm(2)/mL, and 1.5 cm(2)/mL according to ISO 10993 series. The extracts were incubated with HGF cells for 24 and 72 hours. A cell counting kit-8 assay (Dojindo, Kumamoto, Japan) assay was used to examine cytotoxicity. The results were analyzed with the independent t test and 1-way analysis of variance test (P < .05). RESULTS: At all experimental conditions, the extracts of freshly mixed GuttaFlow 2 were nontoxic, whereas the extracts of freshly mixed and set AH Plus and RealSeal sealers were toxic to HGF cells (P < .05). The extracts of set GuttaFlow 2 were toxic at 72 hours (P < .05) and nontoxic at 24 hours. The extracts of freshly mixed MTA were nontoxic at both time points. For the extracts of set MTA, 1.5 cm(2)/mL was toxic at 72 hours and 1.5 cm(2)/mL and 1 cm(2)/mL were toxic at 24 hours (P < .05). CONCLUSIONS: Both GuttaFlow 2 and MTA evoked a less toxic response to HGF cells than AH Plus and RealSeal sealer.

Sealing ability of three single-cone obturation systems: An in-vitro glucose leakage study.

AIM: The aim of this study is to compare the corono-apical sealing ability of three single-cone obturation systems using a glucose leakage model. MATERIALS AND METHODS: A total of 90 extracted maxillary single rooted teeth were selected and their crowns were cut. The root canal of each sample was instrumented using a rotary crown down technique and then divided into four experimental (n = 20 each) and two control groups (n = 5 each). Samples in the experimental groups were filled as follows: Group 1, cold lateral condensation using Gutta-percha/AH Plus; Group 2, single-cone Gutta-percha and AH Plus; Group 3, single-cone Gutta-percha/and GuttaFlow2; Group 4, single-cone Resilon/RealSeal SE after 7 days, the sealing ability of root canal fillings was tested at different time intervals using glucose leakage model. Glucose leakage values were measured using a spectrophotometer and statistically analyzed. RESULTS: The four experimental groups presented significantly different glucose leakage values at all test periods (P < 0.05). At the end of the observation period, the cumulative glucose leakage values of Groups 3 and 4 were significantly lower than those of Groups 1 and 2 (P < 0.05). CONCLUSION: Gutta-percha/GuttaFlow2 or Resilon/RealSeal SE combinations provided the superior sealing ability over the lateral condensation technique.