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.

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.

The Contribution of Various In Vitro Methodologies to Comprehending the Filling Ability of Root Canal Pastes in Primary Teeth.

A void-free obturation during root canal treatment on primary teeth is currently very difficult to attain. In this study, the pulpectomy filling abilities of Bio-C Pulpecto (Angelus, Basil, Londrina, Paraná, Brazil) and of zinc oxide eugenol, or "ZOE" (DenPro, Prevest, New York, NY, USA), were compared using several in vitro techniques. Therefore, 30 primary anterior teeth were used in the present in vitro study. Analysis of variance (ANOVA), including a multiple comparison procedure (Holm-Sidak method, Dunn's Method, or Tukey test), was used. On micro-CT, Bio-C Pulpecto exhibited higher void percentages than did ZOE (10.3 ± 3.8%, and 3.5 ± 1.3%), respectively (p < 0.05). With digital microscopy, higher total void percentages were found in the BC (13.2 ± 26.7%) group compared to the ZOE (2.7 ± 2.8%) group (p < 0.05). With the CLSM, mean tubular penetration depths were higher for Bio-C Pulpecto than for ZOE in all canal thirds (p < 0.05). SEM images demonstrated no tags into dentinal tubules in either group throughout the three thirds. Moreover, higher statistically significant flowability was found for Bio-C (2.657 ± 0.06 mm) compared to ZOE (1.8 ± 0.13 mm) (p < 0.05). The findings of this study indicate that neither ZOE nor Bio-C Pulpecto appears to meet the criteria for an ideal root canal filling paste for primary teeth. This study laid the groundwork for future research by determining how micro-CT, digital microscopy, SEM, and CLSM contribute to our understanding of the filling process of primary teeth. More thorough research on the mechanism of root canal obturation on primary teeth is required to achieve a long-term successful root canal therapy in young children.

Evaluation of Two Shaping Systems and Two Ultrasonic Irrigation Devices in Removing Root Canal Filling Material from Mesial Roots of Mandibular Molars: A Micro CT Study.

We assessed the efficiency of two shaping file systems and two passive ultrasonic irrigation (PUI) devices for removing filling material during retreatment. The mesial canals from 44 extracted mandibular molars were prepared and obturated. The teeth were randomly divided into two groups, and then one group was retreated with Reciproc R25 (VDW, Munich, Germany) (n = 44) and the other group was retreated with 2Shape (TS, Micro Mega, Besançon, France) (n = 44). A micro-computed tomography (CT) scan was taken before and after the retreatment to assess the volume of the filling material remnants. The teeth were then randomly divided into four groups to test two different PUI devices: Irrisafe (Satelec Acteon Group, Merignac, France) and Endo Ultra (Vista Dental Products, Racine, WI, USA). The teeth in Group A were retreated with 2Shape to test the Endo Ultra (n = 22) device, the teeth in Group B were retreated with 2Shape in order to test the Irrisafe (n = 22) device, the teeth in Group C were retreated with Reciproc to test the Endo Ultra (n = 22) device, and Group D was retreated with Reciproc to test the Irrisafe (n = 22) device. A third micro-CT scan was taken after the retreatment to test the PUIs. The percentage of Gutta-Percha (GP) and sealer removed was 94.75% for TS2 (p < 0.001) and 89.3% for R25 (p < 0.001). The PUI significantly enhanced the removal of the filling material by 0.76% for Group A (p < 0.001), 1.47% for Group B (p < 0.001), 2.61% for Group C (p < 0.001), and by 1.66% for Group D (p < 0.001). 2Shape was more effective at removing the GP and sealer during retreatment (p = 0.018). The supplementary approach with PUI significantly improved filling material removal, with no statistical difference between the four groups (p = 0.106).