Application research progress of Er，Cr：YSGG laser in root canal therapy / 口腔疾病防治

@#Erbium，chromium：yttrium scandium gallium garnet（Er，Cr：YSGG）laser is mainly used for root canal treatment，periodontal disease，tooth decay，dentin hypersensitivity，pulp amputation，etc in the field of dentistry.This paper mainly describes the research progress of Er，Cr：YSGG laser in root canal therapy from following four as⁃pects：root canal sealing，sterilization，cavitation effect and the effect on periapical tissue. The experimental results showed that when the operation parameters of Er，Cr：YSGG were 2 ~ 4 w and 20 Hz，it could effectively remove the stained layer of dentin tubules and improve the tightness between materials and dentin. The thermal effect produced by Er，Cr：YSGG energy has a sterilizing effect，while the optical conductivity of the tooth enables the rinse solution to enter deeper tissues，further improving the sterilizing effect. Er，Cr：YSGG also has a cavitation effect，which destroys the surface tension of the deep solution，removing the stain layer and bacteria in the deep layer. However，with the same operation parameters，if Er，Cr：YSGG is not used properly，the thermal effect of Er，Cr：YSGG will cause some damage to the periapical tissues. Therefore，reasonable use time of Er，Cr：YSGG and water cooling conditions are important.

A comparison of the sealing abilities between Biodentine and MTA as root-end filling materials and their effects on bone healing in dogs after periradicular surgery

ABSTRACT Objectives: To compare the sealing ability and biocompatibility of Biodentine with mineral trioxide aggregate (MTA) when used as root-end filling materials. Methodology: The Cell Counting Kit-8 (CCK-8) assay was used to compare the cytotoxicity of MTA and Biodentine. Twenty-one extracted teeth with a single canal were immersed in an acidic silver nitrate solution after root-end filling. Then, the volume and depth of silver nitrate that infiltrated the apical portion of the teeth were analyzed using micro-computed tomography (micro-CT). Seventy-two roots from 3 female beagle dogs were randomly distributed into 3 groups and apical surgery was performed. After six months, the volume of the bone defect surrounding these roots was analyzed using micro-CT. Results: Based on the results of the CCK-8 assay, MTA and Biodentine did not show statistically significant differences in cytotoxicity (P>0.05). The volume and the depth of the infiltrated nitrate solution were greater in the MTA group than in the Biodentine group (P<0.05). The volume of the bone defect was larger in the MTA group than in the Biodentine group. However, the difference was not significant (P>0.05). The volumes of the bone defects in the MTA and Biodentine groups were smaller than the group without any filling materials (P<0.05). Conclusions: MTA and Biodentine exhibited comparable cellular biocompatibility. Biodentine showed a superior sealing ability to MTA in root-end filling. Both Biodentine and MTA promoted periradicular bone healing in beagle dog periradicular surgery models.

Effect of thermal conductivity on apical sealing ability of 4 dental gutta-percha cones / 北京大学学报(医学版)

Objective:To investigate the effect of thermal conductivity on the apical sealing ability of different dental gutta-percha cones during the warm vertical condensation obturation.Methods:Four kinds of dental gutta-percha cones were used in this study:Bio-GP points (BP,B&L,Korea),large-tapered gutta-percha (DP,DENTSPLY,America),PROTAPER Universal gutta-percha points (DPP,DENTSPLY,America) and mtwo gutta-percha points (VP,VDW,Germany).Volume differences method was used to determine the main components and the thermal conductivity determinator was used to measure the thermal conductivity of these dental gutta-percha cones.Furthermore,20 cones randomly selected from each kind of dental gutta-percha cones.And 10 cones of each dental gutta-percha cones,which were cut out the part of 4 mm in length from the apical end,were heated (200 ℃) from the upper end without compression,and the temperature of the gutta perchacones surface was monitored in time by the infrared thermal imager during the whole heating process.In addition,the rest of the 10 cones of each dental gutta-percha cones were used to obturate the root canal in the transparent root canal resin model using warm vertical condensation technique.The cross-sectional surface was observed by stereomicroscope (× 40) at 1 mm and 3 mm from the working length and the gutta-percha obturation area proportion was measured and analyzed.The data were analyzed by one-way ANOVA.Results:The proportion of inorganic fillers (80.90％ ± 1.14 ％) (P ＜ 0.05) and the thermal conductivity (2.247 ± 0.002)of DP was siguificantly higher than BP (79.28％ ± 3.88％,1.179 ± 0.003),DPP (68.46％ 5.09％,0.604 ±0.001),VP (78.86％ ± 1.87％,1.150 ±0.001) (P ＜0.05).During the thermal obturation without compression at the setting temperature (200 ℃),DP could achieve 65 ℃ beyond 1 mm from the heating point,and BP,DPP and VP only reached 65 ℃ within 1 mm.After warm vertical condensation obturation,all the groups showed increased gutta-percha obturation area proportion.At the position of WL-3,DP (96.89％ ±0.03％) showed significantly higher proportion of gutta-percha obturation area than BP (95.47％ ±0.06％),DPP (95.21％ ±0.03％) and VP (95.15％ ±0.03％) (P ＜ 0.05).Conclusion:DP contains more inorganic fillers,possesses higher thermal conductivity,and leads a better apical sealing ability than BP,DPP and VP at the position of WL-3 during warm vertical condensation obturation.

Apical sealing ability of iRoot SP in oval-root canals in vitro / 实用医学杂志

Objective To evaluate the apical sealing ability of iRoot SP root canal sealer in oval-root canal. Methods After root canals were instrumented by Mtwo, 28 premolars with oval-root canal were randomly divided into 2 groups, 14 teeth in each. The root canals were obturated with AH Plus (group A) and iRoot SP (group B) by modified continuous wave condensation technique. The apical leakage was evaluated by dye penetration method and transparent teeth technique. Results Mean depth of leakage was (0.92 ± 0.26) mm for group A and (0.84 ± 0.40) mm for group B. There was no significant difference between the two groups (t=0.506, P > 0.05). Conclusion The apical sealing ability of iRoot SP is equivalent to AH Plus in oval-root canal.

The sealing ability of MTA apical plugs exposed to a phosphate-buffered saline

OBJECTIVE: The aim of this study was to evaluate the influence of exposure of the mineral trioxide aggregate (MTA) - with and without calcium chloride (CaCl2) - to phosphate-buffered saline (PBS) on the apical microleakage using a glucose leakage system. MATERIAL AND METHODS: Sixty root segments were randomly divided into 4 experimental groups (n=15). After resecting the apical segments and enlarging the canals with Gates-Glidden drills, the apical cavities were filled with MTA with or without CaCl2 and the root canals were dressed with a moistened cotton pellet or PBS, as follows: 1) MTA/cotton pellet; 2) MTA/PBS; 3) MTA+10%CaCl2/cotton pellet; 4) MTA+10%CaCl2/PBS. All root segments were introduced in floral foams moistened with PBS. After 2 months, all root segments were prepared to evaluate the glucose leakage along the apical plugs. The amount of glucose leakage was measured following an enzymatic reaction and quantified by a spectrophotometer. Four roots were used as controls. The data were analyzed using Kruskal-Wallis and Mann-Whitney tests (p<0.05). RESULTS: There were no differences between groups 1 and 2 (p>0.05), and 3 and 4 (p>0.05). The addition of CaCl2 to the MTA significantly decreased its sealing ability (p<0.05). CONCLUSION: The interaction with PBS did not improve the MTA sealing ability. The addition of CaCl2 to the MTA negatively influenced the apical seal. .

Sealing Ability of MTA Used as a Root End Filling Material: Effect of the Sonic and Ultrasonic Condensation

Despite the excellent properties of mineral trioxide aggregate (MTA), the condensation technique may have some influence in its sealing ability. The purpose of this study was to compare the sealing ability of sonic and ultrasonic setting of MTA. Thirty-four extracted human teeth had their canals prepared and filled with Sealapex sealer and gutta-percha using the active lateral condensation technique. The teeth were rendered waterproof and apicoectomy performed at 3 mm from the apex. Root-end cavities (3.0 mm deep and 1.4 mm diameter) were prepared with diamond ultrasonic tips. The root-end cavities were filled with Pro-Root MTA® with ultrasonic vibration, sonic vibration or no vibration. The positive control group did not receive any material while the negative control group was totally rendered waterproof. After material set, the specimens were immersed in Rodhamine B for 24 h, under vacuum in the first 15 min, then washed, dried and split longitudinally for evaluating the infiltration at the dentin/material interface. Data were analyzed using ANOVA and Tukey's tests at 5% significance level. Sonic vibration promoted the lowest infiltration values (p<0.05). It was concluded that sonic vibration could be considered an efficient aid to improve the sealing ability of MTA when used as root-end filling material.

Resumo O objetivo deste estudo foi avaliar in vitro, a influência da vibração sônica e ultrassônica no selamento marginal proporcionado pelo MTA. Trinta e quatro dentes humanos tiveram seus canais radiculares instrumentados e obturados com cimento Sealapex® pela técnica da condensação lateral ativa. Os dentes foram impermeabilizados e seccionados os 3 mm apicais. Retrocavidades (3 mm de profundidade e 1,4 mm de diâmetro) foram preparadas com pontas ultrassônicas diamantadas. As retrocavidades foram preenchidas com Pro-Root MTA® com auxílio da vibração ultrassônica, com auxílio da vibração sônica e sem vibração alguma. O grupo controle positivo não recebeu material retrobturador, enquanto que o negativo foi totalmente impermeabilizado. Após a presa do material, os espécimes foram mergulhados em Rodamina B por 15 min em vácuo, permanecendo nesta solução por mais 24 h. Em seguida, foram lavados, secados e clivados longitudinalmente para avaliação da infiltração do corante na interface dentina/material retrobturador. Os dados foram analisados utilizando a análise de variância e o teste de Tukey (p<0,05). Observou-se que apenas a vibração sônica foi diferente apresentando os menores índices de infiltração. Pode-se concluir que vibração sônica contribui com a melhora da capacidade de selamento marginal proporcionado pelo MTA quando empregado como material retrobturador. .

Sealing ability, marginal adaptation and their correlation using three root-end filling materials as apical plugs

OBJECTIVE: This study used dye leakage assay and scanning electron microscopy to evaluate, respectively, the sealing ability and marginal adaptation of three root-end filling materials used as apical plugs, as well as the possible correlation between these properties. MATERIAL AND METHODS: Ninety-eight single-rooted human teeth were prepared to simulate an open apex. The teeth were allocated to three experimental groups (n = 30), which received a 5-mm thick apical plug of (1) gray MTA AngelusTM, (2) CPM TM and (3) MBPc, and two controls groups (n = 4). After immersion in 0.2 percent Rhodamine B solution for 48 h, the teeth were sectioned longitudinally and analyzed by Image Tool 3.0 software. The marginal adaptation between apical plugs and the root canal walls were analyzed by SEM. RESULTS: MBPc had significantly less (p<0.05) apical leakage than the other materials. Regarding marginal adaptation, CPM TM showed the best numerical results, though without statistical significance from the other materials (p<0.05). There was no correlation between the two properties. CONCLUSIONS: When used as apical plugs, the tested root-end filling materials had similar marginal adaptation to the dentin walls, but MBPc had the best sealing ability, as demonstrated by the least apical leakage from all tested materials.

Effect of moisture on sealing ability of root canal filling with different types of sealer through the glucose penetration model / 대한치과보존학회지

OBJECTIVES: To compared the effect of different levels of moisture of root canal on the sealing ability after filling with four different types of sealer. MATERIALS AND METHODS: Single-rooted teeth (n = 90) instrumented to and apical size of 0.06 / 45 were randomly assigned to 12 experimental groups (n = 7 per group), positive/negative control groups (n = 3 per group). The teeth of the experimental groups (a. DRY; b. PAPER POINT DRY; c. WET) were obturated with sealer (Group 1-3: Sealapex; Group 4-6: AH plus; Group 7-9: Tubuli-seal; Group 10-12: EndoRez) and warm vertical compaction method. After 7 days in 37degrees C, 100% humidity, the coronal-to-apical microleakage was evaluated quantitatively using a glucose leakage model. The leaked glucose concentration was measured with spectrophotometer at 1, 3, 7, 14, 21, and 30 days. Data were recorded ad mmol/L and statistically analysed with the two-way ANOVA and Duncan test (p = 0.05). RESULTS: Throughout the experimental period Tubuli-seal/WET (Group 9) showed the highest mean cumulative glucose penetration (178.75 mmol/L), whereas AH plus/DRY (Group 4) had the least (20.78 mmol/L). CONCLUSIONS: The results of this study demonstrated that the moisture condition of root canals at the time of obturation and the type of sealer that was used had a significant effect on leakage and sealing ability. Thus drying procedure according to sealer types is a critical step and should not be missed in endodontic treatment.

Effect of soft chelating irrigation on the sealing ability of GP/AH Plus root fillings / 대한치과보존학회지

The purpose of this study was to evaluate the effect of soft chelating irrigant on the sealing ability of root fillings by using a glucose leakage test. A total of 45 single-rooted teeth were selected for the study. The teeth were decoronated leaving a total length of 13mm. The root canals prepared using K3 NiTi rotary instruments to an apical dimension of size 45(0.06 taper). The specimens were then randomly divided into 3 experimental groups of 13 roots each and 2 control groups of 3 roots each. Specimen in each group were prepared with different irrigation protocols : group 1, 2.5% NaOCl; group 2, 2.5% NaOCl and 17% EDTA; group 3, 2.5% NaOCl and 15% HEBP. The root canals were filled with gutta-percha and AH Plus sealer using lateral condensation. After 7 days in 37degrees C, 100% humidity, the coronal-to-apical microleakage was evaluated quantitatively using a glucose leakage model. The leaked glucose concentration was measured with spectrophotometry at 1, 4, 7, 14, 21 and 28 days. There was a tendency of increase in leakage in all experimental groups during experimental period. HEBP-treated dentin showed no significant difference with EDTA-treated dentin during experimental period. From the 21th day onward, HEBP-treated dentin showed significantly lower leakage than smear-covered dentin. HEBP-treated dentin displayed a similar sealing pattern to EDTA-treated dentin and a better sealing ability than smear-covered dentin. Consequently, a soft chelator(HEBP) could be considered as the possible alternative to EDTA.

Sealing ability of grar MTA AngelusTM, CPM TM and MBPc used as apical plugs

This study evaluated the sealing ability of apical plugs fabricated with gray MTA AngelusTM sealer, CPM TM sealer and MBPc sealer. The root canals of 98 extracted single-rooted human teeth were instrumented with #5 to #1 Gates Glidden drills according to the crown-down technique until the #1 drill could pass through the apical foramen. The specimens were then prepared with K-files, starting with an ISO 50 until an ISO 90 could be visualized 1 mm beyond the apex. After root canal preparation, the external surface of each root was rendered impermeable and roots were assigned to 3 experimental groups (n = 30), which received a 5-mm thick apical plug of gray MTA AngelusTM, CPM TM and MBPc, and two control groups (n=4). The remaining portion of the canal in the experimental groups was filled by the lateral condensation technique. The teeth of each group, properly identified, were fixed on utility wax by their crowns and were placed in plastic flasks, leaving the apex free and facing upward. The flasks were filled with 0.2 percent Rhodamine B solution, pH 7.0, so as to completely cover the root apex of all teeth. The sealing ability was analyzed by measuring 0.2 percent Rhodamine B leakage after all groups had been maintained in this solution for 48 hours. Data were analyzed statistically by Kruskal-Wallis test and Dunn test with a=5 percent. The results showed that, among the tested materials used for fabrication of apical plugs, MBPc sealer had the least amount of leakage with statistically significant difference (p<0.05).

Evaluation of the influence of apical sizes on the apical sealing ability of the modified continuous wave technique / 대한치과보존학회지

This study examined the influence of the apical sizes on the sealing ability of a root canal filling. Thirty-six single rooted teeth with a single canal were divided into 3 groups (n = 12) and instrumented with either the Profile(R) or LightSpeed(R) system to achieve three different apical sizes (master apical file [MAF] of #25, #40, or #60). The teeth were filled with gutta percha using a modified continuous wave technique. The level of microleakage was determined by immersing ten teeth from each group into India ink for 1 week followed by clearing with nitric acid, ethyl-alcohol, and methylsalicylate. The microleakage was measured using vernier calipers. The data was analyzed statistically using Kruskal-Wallis one-way ANOVA and a Student-Newman-Keuls Method. Two teeth from each group were sectioned horizontally at 1, 2, 3 and 4 mm from the apex in order to observe a cross section. The apical size was significantly (p < .05) influenced the level of microleakage. In the Student-Newman-Deuls Method, MAF sizes of #25 and #40; and MAF sizes of #25 and #60, respectively showed a statistically significant difference. There was no significant difference between #40 and #60. In most cross sections, oval-shaped canals were observed, and the irregularity of the internal surface increased with decreasing apical size. There was also an increase in the area of recess, which is the area where the canal space is not filled with either gutta-percha or sealer. When the root canals are filled using a modified continuous wave technique, canal filling with more consistent and predictable outcome may be expected as the apical preparation size is increased.

Comparison of apical sealing ability of continuous wave of obturation technique using EndoTwinn and System B / 대한치과보존학회지

The purpose of this study was to compare the apical leakage of the root canal filled with the System B and the EndoTwinn (the combined application of heat and ultrasonic vibration). Sixty extracted premolars with straight root were cleaned and shaped to size 35. Group SB was obturated using System B and Group ET was filled with EndoTwinn. A size 35 of 0.06 tapered gutta- percha and Adseal were used and the plugger which could be introduced to 4 mm short of working length was selected in the obturation procedure. As the positive control, Group PC was not filled. In Group SB, ET and PC, all external surfaces of each tooth were coated with nail varnish leaving only 1 mm area around the apical foramen. In the negative control of Group NSB and Group NET, all of external tooth surface including apical foramen was coated with the nail varnish. The specimens were immersed in methylene blue dye solution for 2 days. Then the specimens were sectioned at each 1 mm from apex to 5 mm level. The final score of one specimen was given by summing up of the points at all levels. The dye leakage of Group ET was significantly less than that observed in Group SB (p < 0.05). And the frequency of gutta-percha pulling out from root canal when the plugger was removed was more often with the System B than with EndoTwinn but there was no significant difference.

Comparison of apical seal with or without the use of dentin adhesive system / 대한치과보존학회지

The purpose of this study was to compare the sealing ability of root canal obturation with or without the use of dentin adhesive system. Forty extracted human teeth with one canal were selected and decoronated. The teeth were divided into two Groups. The obturation procedure of Group 1 was the same as that of Group 2 with the exception of dentin adhesive system. Group 2 were obturated with dentin adhesive system, AH-26, and gutta-percha. After obturation, the teeth were immersed in methylene blue solution for 84 hours. The teeth were sectioned horizontally at 1.5 mm (Level 1), 2.0 mm (Level 2), 2.5 mm (Level 3) from the root apex using a low speed microtome. Distance of dye-penetrated surface and total dentinal surface were measured using SigmaScan Pro 5.0, and the ratio of dye-penetrated distance to the total dentinal distance was analyzed statistically by Mann-Whitney U-test. 1. In both groups, the mean leakage ratio was decreased cervically. 2. At level 1, there was no significant difference between group 1 and grpup 2 (p > 0.05). 3. At level 2 and 3, group 1 showed significantly higher mean leakage ratio than group 2 (p < 0.05). The results suggest that using dentin adhesive system in root canal obturation procedure reduces the apical microleakage.