Comparison of Fracture Resistance of Two Resin-based Sealers to Root Canal Walls: An In Vitro Study.

AIM AND OBJECTIVE: In the present study, the prepared roots obturated by gutta-percha/AH plus and Resilon/Epiphany were tested and compared for fracture resistance. The study also does a scanning electron microscope (SEM) evaluation of the adaptability of these obturating materials to root canal walls. MATERIALS AND METHODS: One hundred extracted mandibular premolars were decoronated and the dimensions of the roots were standardized. Each root was prepared to a size of #25 with 6% taper. Roots were gauged after preparation and those requiring more preparation were discarded. Seventy-seven prepared roots were finally selected for the study. The samples were then divided into three groups. Group I with 25 specimens was control group in which no obturation was performed, group II with 26 specimens was obturated by gutta-percha/AH plus sealer, and group III with 26 specimens was filled by Resilon/Epiphany. The method for obturation was cold lateral condensation. The samples were then stored at 100% humidity for 2 weeks. One random sample from groups II and III was subjected to SEM analysis. Groups I, II, and III were then subjected to vertical loading in Instron machine. One-way analysis of variance (ANOVA) test and Tukey's multiple comparison test were used for statistical analysis. RESULTS: Group III exhibited the maximum fracture resistance as compared to groups I and II. The least mean fracture resistance of 370.05 N was seen in group II and the maximum mean fracture resistance of 481.05 kN was observed in group III. One-way ANOVA and Tukey's multiple comparison test between groups I, II, and III, group III showed a highly significant resistance to fracture as compared to groups I and II (p < 0.0001). Scanning electron microscope microphotographs showed a better adaptation of Resilon/Epiphany as compared to gutta-percha/AH plus to the root canal. CONCLUSION: The Resilon/Epiphany on obturation of root canals creates a monoblock by penetrating inside the dentinal irregularities, which strengthens the root and provides fracture resistance. This fracture resistance was significantly higher in the present study as compared to groups I and II. CLINICAL SIGNIFICANCE: In the present study, Resilon/Epiphany when used to obturate the prepared canals showed a promising result both in terms of fracture resistance and adaptability to root canal walls. This paves a way for the use of this combination of obturating material not only to strengthen the compromised root strength in clinical scenario but also providing an increased sealing ability which will contribute to the success of root canal treatment.

An In Vitro Evaluation of Apical Leakage in Gutta-percha/ AH Plus and Resilon/Epiphany-filled Root Canals Using Two Dye Penetration Techniques.

AIM: Aim of the present study was to evaluate the apical leakage in gutta-percha/AH plus and resilon/epiphany filled root canals using two dye penetration techniques. MATERIALS AND METHODS: Sixty freshly extracted human single-rooted teeth were collected. The crown portion of each tooth was sectioned from the cementoenamel junction using a diamond disk. The canals were instrumented using Step back technique up to a caliber of 40. The roots were randomly divided into four experimental groups of 15 sample units each. All the groups are obturated using lateral compaction technique. Samples were placed in India ink and stored in an incubator for 7 days after which they were thoroughly washed under tap water and dried. The roots were divided into longitudinal splitting technique with diamond disks and using clearing technique was checked for linear dye penetration using stereomicroscope. The surfaces were scanned and surfaces with greatest dye penetration were measured by using De winter Biowizard software system. RESULTS: The mean leakage for groups I, II, III, and IV are 2.31980, 2.68140, 4.11567, and 4.21047 respectively. One-way ANOVA was applied to the mean leakage scores of different groups, found a significant difference between mean leakage scores. F value of 3.266 and it was found to be significant with a p value of 0.028. Significant differences were obtained for mean comparisons of groups I and III, groups I and IV and groups III and IV. Further, between groups I and II, groups II and III, and groups III and IV no significant differences were observed. CONCLUSION: In conclusion, gutta-percha/AH Plus sealed root canals showed lesser leakage than the Resilon Epiphany groups and there was no significant difference in the two different methodologies used for dye penetration. CLINICAL SIGNIFICANCE: Tightly adapted endodontic filling material is one of the goals in successful clinical endodontics and Improvements in the adhesive technology have fostered attempts to reduce apical and coronal leakage by bonding to the root canal walls to obtain a solid monoblock.

Comparison of warm vertical compaction and cold lateral condensation of α, ß gutta-percha and resilon on apically extruded debris during retreatment.

BACKGROUND: This study was performed to evaluate the amount of apically extruded debris removed from a root canal filled with cold lateral condensation (CLC), and warm vertical compaction (WVC) techniques, using b or a phase gutta-percha with AH-Plus (Dentsply DeTrey, Konstanz, Germany) or Resilon (Resilon Research LLC, Madison, WI) with RealSeal SE (SybronEndo, Amersfoort, The Netherlands). MATERIALS AND METHODS: About 100 human incisor teeth were prepared with a #25.06 NiTi rotary system and divided into five groups according to the filling material used: Group 1: CLC (gutta-percha, AH-Plus); Group 2: WVC (b phase gutta-percha, AH-Plus); Group 3: WVC (a phase gutta-percha, AH-Plus); Group 4: CLC (Resilon, RealSeal SE); and Group 5: WVC (Resilon, RealSeal SE). Extruded debris during the retreatment procedure was collected in preweighed Eppendorf tubes. The times required for retreatment were recorded. RESULTS: The amount of debris extrusion was significantly greater with WVC than CLC in the gutta-percha and Resilon groups (P < 0.001). Using a phase gutta-percha resulted in significantly more debris extrusion than b phase gutta-percha (P < 0.001). In the WVC groups, Resilon caused significantly more debris extrusion than gutta-percha (P < 0.05). Retreatment was faster for CLC than WVC (P < 0.05). CONCLUSIONS: In the retreatment procedure, the amount of apically extruded debris and retreatment duration were dependent on the type of obturation material and technique used.

Comparative evaluation of the vertical fracture resistance of endodontically treated roots filled with Gutta-percha and Resilon: a meta-analysis of in vitro studies.

BACKGROUND: Teeth treated endodontically are more susceptible to vertical root fracture (VRF). Some studies have suggested that obturating the root canals with Gutta-percha or Resilon can reinforce endodontically treated teeth, but a few others have presented conflicting results. These inconsistent results cannot guide clinicians in determining clinical approaches. The objective of this meta-analysis is to evaluate and compare the vertical fracture resistance of endodontically treated root canals obturated with Gutta-percha/AH plus and the Resilon system. METHODS: Comprehensive literature searches were performed in the PubMed, Cochrane Library, ScienceDirect, Web of Science and Embase databases. The titles and abstracts of all of the retrieved articles were independently assessed by two authors according to predefined selection criteria. Data in the included articles were independently extracted. Statistical analyses were conducted using Review Manager 5.3 and Stata 12.0 software. The pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated for the outcome indicators. The level of statistical significance was set at p < 0.05. The Cochran Q test (I2 test) was used to test for heterogeneity among studies. RESULTS: Fourteen randomized controlled in vitro trials were included in the meta-analysis. The results demonstrated that the vertical root fracture resistance of unprepared and unfilled roots was significantly higher than that of roots obturated with Gutta-percha/AH plus (SMD = - 0.69, 95% CI = - 1.34 to - 0.04, p = 0.04) or the Resilon system (SMD = - 0.54, 95% CI = - 1.07 to - 0.00, p = 0.05). The differences in fracture resistance between the roots filled with Gutta-percha/AH plus and the prepared unfilled root canals was not significant (SMD = 0.59, 95% CI = - 0.02 to 1.21, p = 0.06). Roots obturated with Resilon had higher fracture resistance than instrumented unfilled roots (SMD = 0.83, 95% CI = 0.44 to 1.22, p < 0.0001) or roots filled with Gutta-percha/AH plus (SMD = 0.62, 95% CI = 0.01 to 1.23, p = 0.05). CONCLUSIONS: The present study suggests that filling with Gutta-percha/AH plus dose not reinforce endodontically treated roots, whereas obturating with the Resilon system can increase vertical root fracture resistance of prepared roots. As this meta-analysis was based on in vitro studies, it should be careful to extrapolate its conclusion to the clinical context.

Resilon: Review of a New Material for Obturation of the Canal.

Resilon is a thermoplastic synthetic polymer-based endodontic material alternative to gutta-percha. It contains bioactive glass and also radiopaque fillers. It has the same handling properties as gutta-percha. For endodontic retreatment, it may be dissolved with some solvents, such as chloroform or softened with heat. The composition of Resilon and its sealer (Epiphany) bond to dentin and form a monoblock. A review of the literature and a discussion of its properties comparing to other root canal filling materials are presented.

Sealing ability of root-end filling materials.

BACKGROUND: The aim of this research was to compare the apical sealing ability of different root-end filling materials (SuperEBA(®), ProRoot MTA(®), thermoplasticized gutta-percha + AH-Plus(®), thermoplasticized RealSeal(®)), by means of microbial indicators. MATERIALS AND METHODS: Thus, 50 human single-rooted teeth were employed, which were shaped until size 5 0, retro - prepared with ultrasonic tips and assigned to 4 groups, retro-filled with each material or controls. A platform was employed, which was split in two halves: upper chamber-where the microbial suspension containing the biological indicators was introduced (E. faecalis + S. aureus + P. aeruginosa + B. subtilis + C. albicans); and a lower chamber containing the culture medium brain, heart influsion, where 3 mm of the apical region of teeth were kept immersed. Lectures were made daily for 60 days, using the turbidity of the culture medium as indicative of microbial contamination. Statistical analyses were carried out at 5% level of significance. RESULTS: The results showed microbial leakage at least in some specimens in all of the groups. RealSeal(®) has more microbial leakage, statistically significant, compared to ProRoot(®) MTA and SuperEBA(®). No significant differences were observed when compared ProRoot(®) MTA and SuperEBA(®). The gutta-percha + AH Plus results showed no statistically significant differences when compared with the other groups. CONCLUSIONS: All the tested materials showed microbial leakage. Root-end fillings with Super-EBA or MTA had the lowest bacterial filtration and RealSeal shows highest bacterial filtration.

Endodontic Outcome of Root Canal Treatment Using Different Obturation Techniques: A Clinical Study.

OBJECTIVE: To evaluate the clinical outcome of root canal treatment by obturation technique, root canal filling quality, and tooth- and patient-related variables. METHODS: This clinical study investigated the endodontic outcome of 114 teeth treated between the years 2009 and 2012. Three different obturation methods were used: (1) adhesive obturation using the continuous wave of condensation technique with Resilon® (CWR), (2) matching-taper single-cone technique with gutta-percha and AH Plus® (SCGP), and (3) matching-taper single-cone technique with gutta-percha and GuttaFlow® (SCGF). Pre- and postoperative periapical radiographs were performed to detect the presence of endodontic lesions (PAI classification) and to assess the quality of both the obturation and the restoration. Tooth- and patient-related data were collected. RESULTS: The overall endodontic success rate was 75.4% after a mean observation period of 6.3 years. There were no significant correlations between the type or overall quality of obturation and the treatment outcome. Teeth with preoperative lesions had the highest odds ratio (factor of 4.98) for endodontic failure. Tooth- and patient-related variables had no significant effect on endodontic outcome. CONCLUSIONS: The preoperative periapical status of teeth requiring endodontic treatment was a substantial prognostic factor for endodontic outcome, whereas the type of obturation material or technique did not affect it.

Comparison of Apical Sealing Capacity of ActiV GP/Glass Ionomer Sealer Versus Resilon/RealSeal and Gutta Percha/AH plus Sealers.

BACKGROUND: In recent years, concerns have arisen regarding the sealing efficacy of traditional root canal obturation materials such as gutta-percha (GP) and various sealers. The resin-based obturation complexes like RealSealTM (SybronEndo, Orange, CA) and ResilonTM (Resilon Research LLC, Madison, CT) had been developed as replacements for conventional obturation materials, gutta-percha, and various types of sealers. Additionally, ActiV GPTM (Brasseler USA, Savannah, GA), a glass-ionomer-based obturation system, has gained attention. AIM: This in vitro study's objective was to evaluate ActiV GPTM/GI (glass ionomer) sealer's sealing capacity and compare it to that of ResilonTM/RealSeal TM as well as gutta-percha/AH PlusTM (Dentsply International Inc, York, PA) taken as a control. METHODS AND MATERIALS: In this in vitro investigation, 90 freshly excised single-rooted human premolars of the mandible were chosen. According to the substance used to seal the root canals, the teeth were randomly separated into three separate groups (n=30). Group 1: The ActiV GPTM obturation system was used to seal and obturate the canals. Group 2: ResilonTM/RealSealTM was used to obturate and block the canals. Group 3: GP points and AH PlusTM were used to seal the canals employing the lateral condensation methodology. All of the root surfaces-aside from the last 2 mm of the root-were painted with two coats of nail polish before being submerged in 2% methylene blue for a duration of 24 hours at a temperature of 37°C. The highest amount of dye leakage was determined using a stereomicroscope at 20X magnification. RESULTS: The extent of dye penetration at the apical region in specimens of the ActiV GPTM category was 4.93±1.48 mm. The depth of dye penetration at the apical region in specimens of the ResilonTM category was 2.78 ±1.62 mm. The extension of penetration of dye was 0.48± 0.46 mm in specimens of the GP/AH PlusTM category. The degree of microlikeage was maximum in ActiV GPTM specimens and it was minimum in GP/AH PlusTM specimens. The microlikeage in specimens of the Resilon category was greater than GP/AH plusTM while it was lower than ActiV GPTM specimens. The observations were statistically meaningful (p<0.001). CONCLUSION: Based on the results of the dye penetration examination, it can be concluded that the root canal wall sealing capabilities of ActiV GPTM with GI Sealer were inferior to those of GP/AH PlusTM and ResilonTM with RealSealTM.

A Confocal Microscopic Study on Percentage Penetration of Different Sealers into Dentin.

CONTEXT: Three-dimensional seal of the root canal space has always been challenging. The incorporation of gutta-percha and sealer prevents microleakage by bacteria, ensuring a shielded root canal space. However, the penetration of sealer to various depths within the root canal has always been looked with curiosity. AIMS: Thus, the present in vitro study was undertaken to evaluate the percentage and average depth of penetration of Endoflas F. S., AH Plus, and Epiphany sealers into dentinal tubules among the coronal, middle, and apical thirds of the roots following obturation with a lateral compaction technique using Confocal Laser Scanning Microscopy. SETTINGS AND DESIGN: The study is an in vitro randomized control trial. SUBJECTS AND METHODS: Thirty sound central incisors were decoronated at the level of the cementoenamel junction. Working length determination was done followed by a meticulous cleaning, shaping, and under copious irrigation. The teeth were then randomly divided into three groups: Endoflas FS sealer, AH Plus sealer, and Epiphany sealer. On fluorescence treatment, the teeth were sectioned at the midpoint of coronal, middle, and apical third of each root and viewed under confocal laser scanning microscope. STATISTICAL ANALYSIS USED: The results were analyzed using one-way ANOVA, and the significant difference between groups was analyzed with post hoc Tukey test. RESULTS: Epiphany sealer provided with better percentage and depth penetration in comparison to Endoflas FS and AH Plus sealers. Furthermore, the coronal third of the root had better percentage and sealer penetration than the middle and apical thirds. CONCLUSIONS: Sealers tend to provide a firm bond between the tooth and the gutta-percha. They bind, lubricate, and seal the gutta-percha cones to fill the accessory canals. Within the limitations of this study, the superior flow and enhanced setting time Epihany sealers provide better percentage and depth of penetration than AH Plus and Endoflas FS.

CBCT Evaluation of Gutta-Percha Removal Using Protaper and Mtwo Retreatment Files, Wave One, and Hedstrom Files: An Ex Vivo Study.

Objectives: This study aimed to evaluate the efficacy of ProTaper, Mtwo, and WaveOne retreatment files and Hedstrom files for removal of gutta-percha from the straight root canals using cone-beam computed tomography (CBCT). Materials and Methods: Forty freshly extracted single-rooted and single-canal teeth were selected for this study. The teeth were decoronated, and biomechanical preparation was performed up to #30 K-file. The root canals were obturated using lateral compaction technique with gutta-percha and Resilon sealer. The teeth were then randomly divided into 4 groups, and CBCT images were obtained. All the canals were then retreated with either ProTaper retreatment files, Mtwo retreatment files, WaveOne files, or Hedstrom files. The surface area of the remaining filling material after the retreatment procedure was quantified by CBCT. Statistical analysis was performed via one-way ANOVA and the Tukey-Kramer multiple comparisons test. Results: None of the file systems could completely remove the filling material from the canals. Data analysis revealed significant differences between the groups in the apical and middle thirds (P<0.05). Conclusion: All the file systems left some filling material in the canals. Mtwo retreatment files had maximum efficacy for removal of filling materials in comparison with other files. WaveOne files can also be used for root canal retreatment.

In Vitro comparison of the microbial leakage of obturation systems: Epiphany with resilon, guttaflow, and ah plus with gutta percha.

AIM: To compare the microbial leakage of three root canal filling materials: AH Plus with Gutta-percha, Epiphany with Resilon, and Guttaflow using Enterococcus faecalis as the bacterial marker. MATERIALS AND METHODS: In total, 30 caries free, human maxillary incisors with straight roots were used. The teeth were de-coronated with a diamond disc and the length was standardized for all specimens. Access opening was done through the coronal portion and the working length was determined. All the teeth were prepared to a standardized size apically and coronally. The teeth were then randomly divided into three experimental groups each. After obturation of the root canals, the outer surfaces of the teeth were coated with two layers of nail enamel except the apical 2 mm. The teeth were then subjected for bacterial leakage test using E. faecalis as a bacterial marker in dual chamber bacterial leakage model for a period of 30 days. STATISTICAL ANALYSIS USED: Chi-square test. RESULTS: Results showed that Resilon/Epiphany (Group-2) demonstrated less leakage and Gutta-percha/AH Plus (Group-1) showed maximum leakage with the statistically significant difference between the two (P < 0.05). Guttaflow (Group-3) also showed less leakage than Gutta-percha/AH Plus (Group-1) with the statistically significant difference between the two (P < 0.05). There was no statistically significant difference between Resilon/Epiphany (Group-2) and Guttaflow (Group-3). CONCLUSION: Resilon/Epiphany and Guttaflow groups demonstrated less microbial leakage than Gutta-percha/AH Plus group.

Comparative evaluation of sealing ability of gutta percha and resilon as root canal filling materials- a systematic review.

This systematic review aims to comparatively evaluate the sealing ability gutta-percha and resilon as root canal filling materials. A Medline search was conducted to identify in-vitro studies published between October 01, 2004 and October 01, 2019, conducted on human extracted teeth, published in English and testing the sealing ability of gutta-percha and resilon as root canal filling materials using fluid filtration method. The search identified fifty-five published articles. After a thorough screening, five articles meeting the selection, and validity assessment criteria were critically appraised. The results indicated that during the initial time-period, resilon/epiphany sealer has better sealing ability than gutta-percha. However, over a period of time the resilon system demonstrated increased fluid flow. Gutta-percha with AH plus sealer showed the best long term sealing ability.

Resilon: Assessment of Degraded Filling Material in Nonhealed Cases.

INTRODUCTION: The Resilon obturation system (Pentron Clinical Technologies, Wallingford, CT) was discontinued a few years after its introduction as an alternative to traditional gutta-percha and sealer. Ex vivo models support anecdotal reports of degraded Resilon filling material; however, there is no previous clinical report of this degradation. This may represent a significant health concern for the patient and contribute to a higher clinical failure rate of Resilon-obturated root canals. The aim of this study was to determine the proportion of Resilon degradation in nonhealed endodontic cases compared with gutta-percha and sealer. METHODS: Patients previously treated with Resilon or gutta-percha who had a nonhealed root canal that needed retreatment were enrolled. Upon access, the previous filling material was classified as either degraded or intact. If there was a lack of solid, dense material remaining within the canal confirmed by passively placing a size 15 K-file to the working length, the filling material was considered to be degraded. RESULTS: The proportion of degradation between the 2 materials was statistically significant, with Resilon having a higher likelihood of degradation than gutta-percha in the bivariate analysis (P = .0003). CONCLUSIONS: This clinical observational study indicates that Resilon has a higher rate of degradation when compared with gutta-percha in nonhealed cases.

Long-term Outcomes of Endodontic Treatment Performed with Resilon/Epiphany.

INTRODUCTION: Resilon (Resilon Research LLC, Madison, CT) with Epiphany Sealer (Pentron Clinical Technologies, Wallingford, CT) was introduced into the market in 2004 as a new method of root canal obturation. This material as well as the traditionally used gutta-percha with AH Plus sealer (Dentsply Maillefer, Tulsa, OK) were in use over a 9-year span in the University of North Carolina endodontic clinics. Although Resilon was initially thought to create a "monoblock" seal between the material and the canal, in vitro studies later suggested this concept not to be true. The long-term outcome of Resilon using a validated radiographic index and a systematic approach has not been reported. The purpose of this retrospective cohort study was to radiographically evaluate the outcome of Resilon/Epiphany-treated root canals compared with traditional gutta-percha/AH Plus. METHODS: One hundred twenty-five teeth were radiographically evaluated using the periapical index; 80 were treated with Resilon and 45 with gutta-percha. Age, sex, tooth position, and number of months to follow-up were documented, and a multivariate analysis with odds ratio was performed. RESULTS: Resilon-treated teeth were 5.3 times more likely to have a periapical index of 3 to 5 at follow-up compared with gutta-percha (P = .009). Teeth presenting with preoperative lesions, regardless of the material used, were also more likely to present with a lesion at follow-up (P = .04). CONCLUSIONS: Teeth obturated with Resilon were more likely to present with a lesion at follow-up compared with gutta-percha obturated teeth after controlling for the presence of a preoperative lesion and the length to follow-up.

Evaluation of the Effect of MTAD on Expression of Enterococcus faecalis Virulence Factors Considering the Role of Different Obturating Materials.

OBJECTIVES: The aim of this study was to determine the effect of MTAD on the expression of virulence factors of Enterococcus faecalis (E.faecalis) considering the role of Guttapercha/AH26 or Resilon/RealSeal SE as root canal obturating materials. MATERIALS AND METHODS: One-hundred and forty-four single-rooted human teeth were instrumented to a standardized apical size. Root canals were infected by E.faecalis (ATCC 29212). Ninety teeth were irrigated with MTAD and randomly divided into three groups. In two groups, root canals were obturated by either Gutta-percha/AH26 or Resilon/RealSeal SE. Root canals were kept unobturated in the third group. The remaining 54 teeth received no final irrigation. All groups were then subdivided into three timepoint subgroups in which dentin powder was obtained from each sample to determine the expression of specific virulence factors of E.faecalis (efa, esp, gel, fsr) using real-time reverse transcription polymerase chain reaction (RT-PCR). Statistical analysis was performed by one-way analysis of variance (ANOVA) and Tukey's post-hoc test. The statistical power was set at P-value ≤0.05. RESULTS: MTAD was effective against the expression of most of the tested virulence factors, and Gutta-percha/AH26 increased the antibacterial efficacy of MTAD. CONCLUSIONS: MTAD could inhibit the expression of some known virulence factors of E.faecalis at the majority of tested timepoints. This may partly explain some of the mechanisms of antimicrobial efficacy of MTAD against this resistant microorganism which is known as one of the main causes of failure of root canal treatment.

Effect of Smear Clear and Conventional Root Canal Irrigants on Push-Out Bond Strength of Resilon/Epiphany System.

Introduction: The aim of the present study is to compare the effect of SmearClear and sodiumhypochlorite (NaOCl), chlorhexidine (CHX) and normal saline (NS) on the push-out bond strength of Resilon/Epiphany system to dentine. Methods and Materials: In this in vitro study; 48 single-rooted teeth were selected and decoronated from the CEJ. Then the specimens were divided into four groups (n=12). The roots were prepared by single length technique using MTwo rotary system. The final irrigations of the canals were done using 2% CHX, normal saline, 5.25% NaOCl or SmearClear. The canals were obturated by Resilon/Epiphany system. The teeth were cut perpendicular to their longitudinal axis and four 1-mm-thick sections were obtained from coronal and mid root regions. The push-out bond strength of Resilon/Epiphany system to dentin were calculated and bond failure patterns were assessed. The data were subjected to two-way analysis of variance and Tukey's tests. Results: The highest bond strength values were reported for SmearClear and the lowest values for the NS solutions. The effects of irrigant type (P<0.05) and canal area (P<0.0001) on the bond strength of Resilon to dentin were significant (P<0.05). Higher bond strength values were obtained in the mid root areas compared to the coronal regions. In two-by-two comparisons, significant differences in bond strength were found between SmearClear and normal saline (P<0.05) while the other irrigants showed no significant differences (P>0.05). Conclusion: SmearClear solution was able to increase the push-out bond strength of Resilon to the dentin similar to other irrigants (NaOCl and CHX). Therefore, it can be used for the root canal irrigation and smear layer removal in the clinical situations.

An In vitro Comparison of Pushout Bond Strength of Resilon with MetaSEAL and AH Plus Sealers.

AIM: The aim of this study is to evaluate and compare the pushout bond strengths of Resilon with two different sealers: Resilon/MetaSEAL (methacrylate based) and Resilon/AH Plus (an epoxy resin-based sealer). MATERIALS AND METHODS: Forty single canal anterior teeth were decoronated at cementoenamel junction and standardized to 10 ± 1 mm length. Working length was determined followed by biomechanical preparation. Then, the specimens were randomly assigned into two groups of 20 teeth each based on the sealer used with Resilon. All canals were obturated using single-cone obturation technique. Root samples were prepared for pushout testing. The universal testing machine gave the debonding force for individual specimen. This was done for all the specimens. STATISTICAL ANALYSIS: This was done by using unpaired Student's t-test. RESULTS: The roots filled with Resilon/MetaSEAL had higher bond strength (1.49 ± 0.09 MPa) compared to Resilon/AH Plus (0.90 ± 0.04 MPa) group. The difference in bond strength was statistically significant (P = 0.0000). CONCLUSION: Through this pushout bond strength test, it could be noted that MetaSEAL did appear to bond to the dentin and could be used as a potential endodontic sealer.

Long-term Clinical Outcome of Teeth Obturated with Resilon.

INTRODUCTION: Although Resilon has been in clinical use as an endodontic obturation material for more than a decade, there is a lack of long-term clinical outcome studies. The purpose of this retrospective case-control study was to compare long-term clinical outcomes in teeth obturated with Resilon/RealSeal SE (RS) and GP/AH Plus (GP). METHODS: One hundred teeth treated at Texas A&M University College of Dentistry between 2007 and 2012 were included; 50 teeth were obturated with RS and 50 with GP. All cases were initial treatments without preoperative periapical radiolucencies. Success and failure were assessed on the basis of clinical signs and symptoms and/or the presence of periapical radiolucency. Chi-square test and odds ratio were used to determine the association between the obturation material and outcome. Potential prognostic factors were evaluated including age, sex, tooth location, preoperative diagnosis, and one versus multiple visits. RESULTS: The average recall time for RS was 5.8 years and 6.6 years for GP. Fifty-six percent of RS-obturated teeth were classified as successful at recall compared with 88% of GP-obturated teeth. RS had 5.7 times greater odds of failure compared with GP (P < .001). When periapical radiolucencies were present, they tended to be larger and involve multiple roots in the RS group compared with GP group. None of the prognostic factors examined were found to have any significant effect on outcome. CONCLUSIONS: Within the limitations of this study, teeth obturated with RS had 5.7 times greater chance of failure compared with teeth obturated with GP.

Fracture Resistance of Roots after Application of Different Sealers.

INTRODUCTION: Vertical root fracture inevitably leads to tooth extraction. Thus, root filling with obturating materials and sealers that can reinforce the tooth would be an ideal way to reduce fracture in root treated teeth. This study aimed to assess the fracture resistance of roots following the application of different sealers including Epiphany, iRoot sealer and AH-plus. METHODS AND MATERIALS: Fifty extracted human single-canal premolars without caries, curvature or cracks were used in this study. Tooth crowns were cut to yield 13-mm-long roots. Five roots were put in the negative control group and were left unprepared. Forty-five canals were prepared using ProTaper rotary files up to F3 and were then randomly divided into three groups based on the sealer type (n=15). The root canals were filled using cold lateral condensation technique with gutta-percha and AH-Plus sealer, gutta-percha and iRoot sealer and Resilon and Epiphany sealer, in groups one to three, respectively. The roots were then mounted in acrylic molds for fracture resistance testing and subjected to compressive load at a crosshead speed of 1mm/min until fracture. Data were analyzed using the one-way ANOVA. RESULTS: The mean fracture resistance was 673.38±170.42 N in AH-Plus, 562.00±184.68 N in iRoot, 708.03±228.05 N in Resilon and 592.59±117.29 N in the control group. No statistically significant difference was found between the experimental groups and the negative control group (P=0.26). CONCLUSION: Application of AH-Plus, bioceramic and Resilon sealers did not change the fracture resistance of roots compared to that of unprepared root canals.

Antimicrobial effect of three disinfecting agents on Resilon cones and their effect on surface topography: An in vitro study.

AIM: The objective of this study was to evaluate the effectiveness of 5.25% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), and 2% peracetic acid (PAA) in disinfecting Resilon cones and to evaluate topographical changes microscopically under scanning electron microscope (SEM) after rapid chemical disinfection. MATERIALS AND METHODS: Resilon cones were disinfected in an ultraviolet (UV) light chamber for 20 min and contaminated by immersing in a microbial suspension of Enterococcus faecalis for 30 min. The contaminated cones were then immersed in the 5.25% NaOCl, 2% CHX, and 2% PAA for 1 min, 5 min, and 10 min, separately. The cones were then incubated at 37°C in thioglycollate broth for 7 days and examined for turbidity. The samples showing turbidity were subcultured on blood agar and incubated at 37°C for 48 h. Gram staining was done to confirm that the cultured bacteria were E. faecalis. Surface changes of disinfected Resilon cones were evaluated under SEM. STATISTICAL ANALYSIS USED: The data were analyzed statistically using Kruskal-Wallis, analysis of variance (ANOVA), and Mann-Whitney U-test. RESULT: In eliminating E. faecalis, 5.25% NaOCl was most effective followed by 2% PAA and 2% CHX. Topographic examination of tested Resilon cones revealed some surface deposits after disinfection with 5.25% NaOCl and 2% CHX, whereas 2% PAA caused surface erosion. CONCLUSION: In disinfecting Resilon cones, 5.25% NaOCl is most effective followed by 2% PAA and 2% CHX.