Comparison of two obturation techniques on adhesion and proliferation of human periodontal ligament fibroblasts / Comparación de la adhesión y proliferación de fibroblastos periodontales humanos en dos técnicas de obturación endodóntica

The present study aimed to compare the adhesion and proliferation of human periodontal ligament fibroblasts (hPDL) in transverse sections of the teeth sealed with two different obturation techniques, BioRoot RCS/hydraulic obturation (HO) and AH-Plus/continuous-wave condensation (CWC). The techniques were tested using an in vitro model to simulate the interaction between periodontal tissues and the materials. The root canals were instrumented and sterilized. A total of 15 samples were obturated with BioRoot RCS/HO and 15 samples with AH-Plus/CWC. Then, roots were sectioned to obtain obturated teeth slices, and hPDL cells were seeded onto the root slices. The results were obtained at intervals of 4 and 24h for cell adhesion; and at 3,7,14, and 21 days for cell proliferation. Empty cell culture plates were use as controls. The cell adhesion was increased at 4 and 24h for both groups, with an increased response observed in the BioRoot RCS/HO group (p<0.05). The difference in cell proliferation was also found between experimental groups. After 14 days of culture, BioRoot RCS/HO group showed an increase response than control and AH-Plus/CWC groups (p<0.05), and after 21 days both groups behaved better than control group, with an increased response observed in the BioRoot RCS/HO group. This study demonstrated that both root canal sealers allow the attach and growth of periodontal ligament fibroblasts, with an increased biological response in the BioRoot RCS/HO group.

El presente estudio se enfocó en comparar la adhesión y proliferación de fibroblastos de ligamento periodontal humano (hPDL) en secciones transversales de raíces previamente obturadas con dos técnicas de obturación diferentes: obturación hidráulica empleando cono único de gutapercha y BioRoot RCS como sellador (HO), y obturación de condensación de onda continua y AH-Plus como sellador (CWC). Los selladores se usaron en un modelo in vitro que simula la interacción entre los tejidos periodontales y los materiales de obturación. Los conductos radiculares fueron instrumentados, esterilizados y obturados. La muestra se compuso de un total de 15 raíces con la técnica BioRoot RCS/HO y 15 raíces con la técnica AH-Plus/CWC. Las células de hPDL fueron sembradas en condiciones estándar de cultivo sobre las raíces seccionadas. Los resultados fueron obtenidos a intervalos de 4 y 24h para adhesión celular, y a los 3,5,7,14 y 21 días de cultivo para proliferación celular. La adhesión celular a las 4 y 24 horas mostró ser diferente para ambas técnicas en comparación con el grupo control, siendo más importante en el grupo BioRoot RCS/HO. La diferencia en la proliferación entre grupos se observó a los 14 días de cultivo, únicamente para el grupo BioRoot RCS/HO; Sin embargo para el día 21 ambas técnicas mostraron mayor proliferación celular que el grupo control, con mejor respuesta para el grupo BioRoot RCS/HO. Este estudio ha demostrado que ambos selladores de conductos permiten la adhesión y crecimiento de fibroblastos de ligamento periodontal, siendo el grupo BioRoot RCS/HO el que mostró mayor biocompatibilidad.

A comparison of the physicochemical properties of AH Plus Jet with samples taken from the beginning, middle and final portions of the automix syringe system

Aim To evaluate physicochemical properties and semi-quantitative elemental analysis of AH Plus Jet with samples from the beginning, middle and final portions of the automix syringe system. Methodology Three experimental groups based on the source of the material used (beginning, middle and final portion) were established for each of the evaluated properties. Setting time, flow and radiopacity were evaluate following ANSI/ADA n. 57 specification. Set specimens was used in the semi-quantitative elemental analysis in an energy-dispersive X ray spectroscopy and scanning-electron microscopy (EDS/SEM). Statistical analysis was performed using one-way ANOVA followed by Tukey test (P<0.05). Results Flow, setting time, solubility and EDS/SEM tests showed no significant differences among the three portions of the automix syringe (P>0.05). Radiopacity test showed significant differences in the beginning of the syringe comparing to the middle and final portions (P<0.05). EDS/SEM analysis identified the presence of C, O, Al, Ca, Zr and W. The element Al, however, was found only in the final portion of the syringe. Conclusions The results of AH Plus Jet suggested an adequate ratio of the components, without segregation between organic and inorganic components, since the results of setting time, flow, solubility and EDS/SEM analysis presented similar values regardless of the portion of the syringe from where the sealer was taken.

Effect of dopamine pretreatment on root canal bonding with AH-plus sealer / 口腔疾病防治

Objective@# To observe the effect of dopamine pretreatment of the root canal on improving the bonding performance of AH-plus sealer.@*Methods @# A total of 32 freshly isolated permanent teeth with a single canal were collected, with no caries, no fracture of roots, and a root canal curvature<10°. All sample root canals were prepared to F2 with ProTaper rotating nickel-titanium instruments and then treated with 1 mg/mL, 2 mg/mL, or 3 mg/mL dopamine solution for 24 hours and divided into 4 groups (n = 8): 0 mg/mL dopamine group (blank control group), 1 mg/mL dopamine group, 2 mg/mL dopamine group, and 3 mg/mL dopamine group. Scanning electron microscopy was used to observe the combination of dopamine and root canal dentin wall; laser confocal scanning microscopy was used to observe the penetration of AH-plus sealer; and root canal filling was performed with AH-plus sealer and gutta-percha tip using the cold gutta-percha lateral pressure technique. The root canal samples were cut horizontally at the middle and the apical third sections of the root with a slice thickness of 1-2 mm. The push-out test was carried out under an Instron universal testing machine to compare the push-out bonding strength between each group. @*Results @#Scanning electron microscopy showed that most of the dentinal tubules were open in the control group after 0 mg/mL dopamine solution treatment for 24 hours. In the 1 mg/mL group, a small number of dopamine particles on the surface of the dentin tubules in the inner wall of the root canal were loose and unevenly distributed. In the 2 mg/mL group, most of the dentinal tubules were covered by dopamine particles, and the dopamine layer was uniform and dense. In the 3 mg/mL group, a large number of dopamine particles were deposited at the mouth of the dentinal tubules, but the distribution was uneven. Dopamine and AH-plus sealer can be seen to simultaneously infiltrate into dentinal tubules under a confocal laser scanning microscope. The interaction of the two factors, the anatomical location and dopamine concentration, had no significant effects on the bonding strength of AH-plus sealer (P>0.05). Root canals treated with 2 mg/mL dopamine had the highest bonding strength in all groups (P<0.05). Analysis of the push-out test of bonding strength with AH-plus sealer at different anatomical locations showed significant differences (P<0.05). The push-out bonding strength of the AH-plus sealer in the middle third section of the root was higher than that in the apical third section of the root.@*Conclusion@# Different dopamine concentrations could affect the bonding strength of AH-plus sealer in root canals. When treated with 2 mg/mL dopamine for 24 hours, the bonding effect of AH-plus sealer in root canals was improved.

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.

Physicochemical properties of two epoxy resin-based sealants: Topseal® and AdSeal™. A comparative study / Propiedades físico-químicas de dos selladores a base de resina epóxica: Topseal® y AdSeal™. Estudio comparativo

Abstract Introduction: a new epoxy resin-based root-canal sealer (AdSeal™) recently appeared on the market. The aim of this study was to evaluate the radiopacity, flow rate, and film thickness of this sealant compared to Topseal®. Methods: the tests were conducted in compliance with ISO 6876:2012 standards. To evaluate radiopacity, 5 discs of each sealant measuring 10 mm in diameter by 1 mm thick were crafted, comparing their radiographic density in mm of aluminum (Al). For flow rate analysis, 0.05 ml of sealant were placed between 2 glass plates under a weight of 120 g for 10 minutes. The diameters of the formed discs were measured with a calibrator and analyzed with the imageJ software. For film thickness analysis, the sealants were placed between 2 glass plates, applying a load of 150N with a universal testing machine (AGIS 5KN) for 10 minutes. Distance between the glass plates was measured using a stereomicroscope at three equidistant points. Results: Topseal® showed more radiopacity (Wilcoxon p < 0.05) and less flow rate than AdSeal™, with statistically significant differences (Anova p = 0.0001863). The film thickness values are above the limit allowed by standard 6876, possibly because of the methodology used in this study; however, no statistically significant difference was found between the sealants (Anova p = 0.4927). Conclusions: the radiopacity and flow rate of AdSeal™ and Topseal® sealants comply with the ISO 6876:2012 standard, but the film thickness values fail to meet the standard.

Resumen Introducción: un nuevo sellador de conductos radiculares a base de resina epóxica (AdSeal™) apareció recientemente en el mercado. El objetivo de este estudio consistió en evaluar la radiopacidad, fluidez y espesor de película de este sellador comparado con el Topseal®. Métodos: las pruebas fueron realizadas en concordancia con la norma ISO 6876:2012. Para evaluar la radiopacidad se elaboraron 5 discos de cada sellador de 10 mm de diámetro por 1 mm de espesor, comparando su densidad radiográfica en mm de aluminio (Al). Para el análisis de fluidez se colocaron 0,05 ml de sellador entre 2 placas de vidrio bajo un peso de 120 g por 10 minutos; los diámetros de los discos formados se midieron con un calibrador y fueron analizados con el software imageJ. Para el análisis de espesor de película los selladores se colocaron entre 2 placas de vidrio, se aplicó una carga de 150 N con una máquina universal de ensayos (AGIS 5KN) por 10 minutos, y la distancia entre las placas de vidrio fue medida con ayuda de un estereomicroscopio en tres puntos equidistantes. Resultados: el Topseal® tuvo mayor radiopacidad (Wilcoxon p < 0,05) y menor fluidez que el AdSeal™ con diferencias estadísticamente significativas (Anova p = 0,0001863). Los valores de espesor de película están por encima del límite permitido por la norma 6876, posiblemente por la metodología utilizada en el estudio; sin embargo, no se encontró diferencia estadísticamente significativa entre los selladores (Anova p = 0,4927). Conclusiones: la radiopacidad y fluidez de los selladores AdSeal™ y Topseal® cumplen con la Norma ISO 6876:2012, pero los valores de espesor de película no cumplen con la norma.

The Effect of AH Plus and GuttaFlow Bioseal Sealers on the Fracture Resistance of Endodontically Treated Roots Instrumented with Reciprocal Rotary Systems

Objective: The objective of this study was to assess and compare the fracture resistance of roots treated endodontically using WaveOne gold, Reciproc blue, AH plus sealer and GuttaFlow Bioseal sealer. Materials and methods: Total 48 human mandibular premolars with single root were decoronated to a length of 13 mm. The roots were arbitrarily divided into 3 main groups (n=16 each group). Group I control group (roots were instrumented but not obturated), Group II obturated with gutta-percha and GuttaFlow Bioseal sealer and Group III obturated with gutta-percha and AH plus sealer. Each main group was additionally divided into 2 subgroups (n=8 each subgroup) conforming to the system used in root canal preparations, Subgroup A: Reciproc blue system and Subgroup B: WaveOne gold system. All root samples were kept for 1 week at 100% humidity to permit the sealers to set completely. Each sample was then exposed to fracture test utilizing a universal test machine, the data were analyzed statistically with one-way ANOVA test, two-way ANOVA test and Dunnett test (2-sided) at a significant level of 0.05. Results: The results revealed that the highest mean value of fracture resistance was noted in Group IIIB (611.125) followed by Group IIIA (543.250), Group IIB (519.875), Group IIA (511.875), Group IB (270.125) and Group IA (267.875) respectively with statistically highly significant differences among the different groups when compared to the control group. Conclusion: From the results of this study, it seems that the use of AH plus and GuttaFlow Bioseal sealers improved the fracture strength of instrumented roots whereas preparation of the root canals with WaveOne gold and Reciproc blue systems without obturation weakened the tooth structures.

Effect of Final Irrigating Solutions on Smear Layer Removal and Penetrability of an Epoxy Resin based Sealer into Dentinal Tubules

Introduction: During instrumentation smear layer formationoccurs on dentinal wall and for a successful root canal itsremoval is necessary. Aim of the study was to compare effectof 17% EDTA, MTAD & 18%Etidronic acid (HEBP) + 5%NaOCl, irrigating solutions on smear layer removal andpenetrability of AH Plus sealer into dentinal tubules usingscanning electron microscopy (SEM).Material and methods: Sixty single rooted mandibularpremolars, were divided into three groups (n=20).Group -I17% EDTA, Group -II MTAD, Group -III 18%Etidronic acid+5% NaOCl. The final rinse was done by 5ml of solution for2 minutes. Ten samples from each group were evaluated atmiddle and apical thirds for smear layer removal using SEM.Remaining ten samples of each group were obturated withgutta-percha & AH PLUS sealer and evaluated at 5mm abovefrom the root apex for sealer penetration using SEM.Results: At middle 3rd no difference in smear layer removalwas seen between Group –I and Group -II For apical 3rdGroup- II showed better smear layer removal than Group–I and Group- III. Thus both in middle and apical thirdsMTAD showed better smear layer removal. For mean sealerpenetration Group -II showed a highest depth of sealerpenetration i.e, 231.37±18.12µm followed by Group -I154.95±22.53µm and Group –III 125.99±17.39µmConclusion: MTAD is effective in smear layer removal fromboth middle and apical thirds. Maximum depth of sealerpenetration was seen in MTAD group followed by EDTAgroup and least in Etidronic acid group

Apical sealability in extracted teeth by the root canal filling agents GuttaFlow and AH Plus: a systematic review / 口腔疾病防治

Objective@#To compare the apical sealing effects of two root canal fillers, GuttaFlow and AH Plus, for clinical reference.@* Methods@#The Cochrane system evaluation method was used to search the Cochrane Library, Embase, CBM, PubMed, CNKI, Weipu, and Wanfang databases. Additionally, relevant journals and conference papers were manually retrieved, and relevant randomized controlled trials were collected. Two reviewers independently evaluated the quality of each study and extracted the data. A meta-analysis was performed using the RevMan5.3 software for homogenous studies, and a descriptive analysis was performed for studies with poor homogeneity.@*Results@#In total, 10 randomized controlled trials containing 398 isolated teeth were included. The meta-analysis results showed that the difference in apical microleakage was statistically significant at 1 week and 3 months [1 week: MD=-0.13, 95% CI (-0.22,-0.04), P=0.007; 3 months: MD=-1.27, 95% CI (-1.94,-0.60), P=0.000 2] but not at 6 months [MD=-0.10, 95% CI (-0.26, 0.06), P=0.23].@* Conclusion@#Based on existing research results, GuttaFlow may achieve better results than AH Plus in the short term (≤ 1 week). Because it is subject to limitations of time, quality, and research methods, this conclusion requires more long-term, high-quality, large-sample, multimeasurement randomized controlled trials for further validation.

Comparative Evaluation of Radicular Push-out Bond Strength of EndoSequence BC, MTA FillApex, Apexit Plus and AH Plus Sealers as Affected by the Modified Plunger: Base Orifice Size Relation

Background: Sealers are universally used along with gutta-percha to obturate the root canals in three dimensions. Push-out bond strength is considered appropriate to measure the adhesion capacity of sealers. Aim: To compare the bond strength of recently introduced bioceramic sealer with commonly used sealers and to evaluate the effect of plunger: base orifice size ratio on push-out bond strength. Methods:One hundred mandibular premolars with single canals were decoronated and instrumented up to master apical file F3 Protaper. Specimens were randomly divided into four groups (n=25) based on the sealer used: Group 1-EndoSequence BC Sealer, Group 2-MTA FillApex sealer, Group3-Apexit Plus sealer & Group 4-AH Plus sealer and obturated using cold lateral compaction technique. After two weeks, 1±0.1mm thick slice of each radicular third of specimens was subjected to push-out testing with modified and standardised plunger: base orifice size ratio for each slice and bond strength calculated. Subsequently the slices were observed under stereomicroscope for failure mode analysis. Results: Results showed that AH Plus sealer had the highest overall bond strength followed by EndoSequence BC sealer and MTA FillApex while as Apexit Plus had lowest bond strength. Bond strength of all sealers reduced from coronal to apical direction except in EndoSequence BC sealer which showed better strength in critical apical third. Higher bond strength values were obtained due to modified relation of plunger with base orifice size. Conclusion: Bond strength of all sealers tested except EndoSequence BC reduces in apical direction and is impacted by plunger: base orifice size ratio.

Capacidade de selamento e penetração intratubular do MTA Fillapex e do AH Plus em dentes humanos / Sealing ability and penetration intratubular MTA Fillapex and AH Plus in human teeth

Introdução: O MTA é um importante material de uso na odontologia, com boas propriedades biológicas. As respostas experimentais aos cimentos endodônticos que utilizam este composto no selamento e preenchimento do sistema de canais radiculares, aliados a uma boa instrumentação e limpeza, podem ser importantes no processo de reparo periapical. Objetivo: Avaliar in vitro a profundidade de penetração de dois diferentes cimentos endodônticos nos túbulos dentinários e a infiltração bacteriana em obturações com os cimentos AH Plus e MTA Fillapex. Material e método: 34 pré-molares monorradiculados humanos foram selecionados, suas coroas removidas e suas raízes padronizadas em 16 mm, a seguir foram, então, divididos aleatoriamente em dois grupos de 15 espécimes e instrumentados com o sistema rotatório Pro Taper. Um grupo foi obturado com o cimento AH Plus (Grupo AH) e outro com MTA Fillapex (Grupo FI). Nestes grupos, avaliaram-se a infiltração coronária de bactérias para Enterococcus Faecalis e a profundidade de penetração nos túbulos dentinários. Para a aferição da infiltração bacteriana, usou-se o teste exato de Fisher; para a penetração intratubular, usou-se o teste-t. Resultado: Para a infiltração bacteriana, considerando o número de amostras infiltradas para AH e MTA Fillapex, houve diferença estatística significativa (p=0,0341). Na avaliação da penetração intratubular, a diferença entre os dois grupos de cimentos foi considerada estatisticamente significativa (p=0,0006). Conclusão: Ambos os cimentos apresentaram infiltração bacteriana, sendo que o MTA Fillapex teve pior desempenho. A capacidade de penetração nos túbulos dentinários do AH Plus foi significativamente maior que a do MTA Fillapex.

Introduction: The MTA is an important use in dentistry material with good biological properties. The experimental responses to sealers using this compound in the sealing and filling of the root canal system, combined with a good instrumentation and cleaning, may be important in the periapical healing process. Objective: To evaluate in vitro penetration depth of two different sealers in dentinal tubules and bacterial infiltration in fillings with AH Plus and MTA Fillapex cements. Material and method: 34 premolars human monorradiculados were selected, their removed and their standardized root crowns in 16mm, after then randomly divided into two groups of 15 specimens, and instrumented with rotary system Pro Taper. One group was obturated with cement AH Plus (group HA) and another MTA Fillapex (FI Group). These groups are evaluated for coronary infiltration of bacteria Enterococcus faecalis and the depth of penetration in the dentinal tubules. For the measurement of bacterial infiltration used Fisher's exact test for Intratubular penetration we used the t-test. Result: For bacterial infiltration, considering the number of infiltrated samples AH and MTA Fillapex, there was a statistically significant difference (p = 0.0341). In the evaluation of intratubular penetration, the difference between the two groups of cement was statistically significant (p = 0.0006). Conclusion: Both cements showed bacterial infiltration and the MTA Fillapex had worse performance, capabilities to enter the dentinal tubules AH Plus was significantly higher than the MTA Fillapex.

Efeito de diferentes sistemas de obturação na resistência à fratura de raízes tratadas endodonticamente / The Influence of different obturation systems on the fracture resistance of endodontically treated roots

Objective: This study aimed to compare the fracture resistance of endodontically treated roots filled by different obturation systems. Material and methods: Ninety-six maxillary central incisors were used and decoronated, retaining 12 mm of the roots. On the basis of obturation systems, the roots were randomly divided into 4 groups (n=24): Group1 (COGR): control group (unprepared, unfilled), Group 2 (AVGR): ActiV GP points/ActiV GP sealer, Group 3 (GPGR): Gutta percha points / AH plus sealer, and Group4 (GAGR): Gutta percha points/ActiV GP sealer. The last three groups were obturated with the single cone technique. The roots were then stored in 100% relative humidity at 37 °C for 2 weeks. A vertical compressive force was exerted in a universal testing machine until fracture occurred. Data were statistically analyzed using one-way ANOVA. Results: Mean (SD) failure loads for groups ranged from 920.51 ± 210.37 to 1113.44 ± 489.42 N. The fracture resistance between the different study groups indicated no statistical difference (p>0.05). Conclusions: ActiV GP system did not exert a significant effect on the fracture resistance of endodontically treated teeth.(AU)

Objective: Comparar a resistência à fratura de raízes tratadas endodonticamente obturadas através de diferentes sistemas. Materiais e Métodos: Noventa e seis incisivos centrais superiores foram utilizados, tiveram as coroas removidas, restando 12 mm de raíz. De acordo com o sistema de obturação, as raízes foram divididas em 4 grupos (n=24): Grupo1 (COGR): grupo controle (sem preparo, sem preenchimento), Grupo2 (AVGR): cones ActiV GP / cimento ActiV GP, Grupo3 (GPGR): cones de guta percha / cimento AH plus, e Grupo4 (GAGR): cones de guta percha / cimento ActiV GP. Os últimos três grupos foram obturados através da técnica de cone único. As raízes foram armazenadas em 100% de umidade relativa a 37 °C durante 2 semanas. Uma força compressiva vertical foi aplicada através de uma máquina de ensaio universal até ocorrer fratura. Os dados foram analisados estatisticamente através de ANOVA ­ 1 fator. Resultados: A carga média (SD) obtida no momento da falha variou entre 920.51 ± 210.37 até 1113.44 ± 489.42 N. A resistência à fratura entre os diferentes grupos estudados não indicaram diferença estatística. Conclusão: O sistema ActiV GP não exerceu um efeito significante na resistência à fratura em dentes tratados endodonticamente.(AU)

Mixing failures of endodontic sealers: an in vivo biocompatibility study / Falhas durante espatulação de cimentos endodônticos: um estudo de biocompatibilidade in vivo

Objectives: Evaluate, in vivo, the influence of mixing failures on endodontic sealers. Material and Methods: To alveolus analysis, 80 rats were divided into Sealapex® and AH Plus® groups. Within each group, the sealer was subjected to either partial (incomplete homogenization­ simulating handling failures) or total mixing (complete homogenization) over two periods of 7 and 30 days (n = 20). The maxillary incisor was extracted and a polyethylene tube containing the sealer was inserted. To quantify edema, 40 male rats were divided into four groups (n = 10). The animals received 2% Evans Blue intravenously, and either AH Plus® or Sealapex® was injected subcutaneously. The rats were euthanized after 3 or 6 hours and analyzed in a spectrophotometer (630 ƞm). To analyze the subcutaneous tissue, 20 rats received polyethylene tube implants with the sealers in the dorsal area (n=10), then euthanized after either 7 or 30 days, and inflammation was evaluated according to an inflammatory cells score. Results: In the alveolar 7-day group, control group presented an inflammation score 1, while all other groups presented a score 2, except AH plus® total mix group (3). After 30 days, all groups presented a score 1. The edemogenic test showed less edema in Sealapex® groups (p < 0.5). In subcutaneous 7-day period, all groups presented score 2. In 30 days, all groups revealed score 1, except AH Plus® partial mix group (2). Conclusion: Regarding mixing of the sealers, there were no significant differences among the groups (AU)

Objetivo: Avaliar, in vivo, a influência das falhas de espatulação de cimentos endodônticos. Material e Métodos: Para análise alveolar, 80 ratos foram divididos nos grupos Sealapex® e AH Plus®. Em cada grupo, o cimento foi espatulado de forma parcial (homogeneização incompleta, simulando falhas) ou total (homogeneização completa) em dois períodos de 7 e 30 dias (n=20). O incisivo superior foi extraído e um tubo de polietileno contendo o cimento foi inserido. Para quantificar edema, 40 ratos foram divididos em quatro grupos (n = 10). Os animais receberam Azul de Evans 2% intravenoso, e AH Plus® ou Sealapex® injetados no tecido subcutâneo. Após 3 ou 6 horas foram eutanasiados e analisados em espectrofotômetro (630 ƞm). Para analisar a resposta subcutânea, 20 ratos receberam implantes de tubo de polietileno com os cimentos na região dorsal (n = 10), eutanasiados após 7 ou 30 dias, e a inflamação foi avaliada de acordo com um escore de células inflamatórias. Resultados: Na análise alveolar em 7 dias, o grupo controle apresentou escore 1 de inflamação, enquanto que todos os outros grupos apresentaram 2, com exceção do AH plus® espatulação total (3). Após 30 dias, todos os grupos apresentaram escore 1. O teste edemogênico mostrou menor edema nos grupos Sealapex® (p < 0,5). No período subcutâneo de 7 dias, todos os grupos apresentaram escore 2. Em 30 dias, todos os grupos revelaram escore 1, exceto AH Plus® espatulação parcial (2). Conclusão: Não houve diferença estatística significante entre os cimentos quanto à espatulação. (AU)

Physical properties of a new resin-based root canal sealer in comparison with AH Plus Jet

PURPOSE: The aim of this study was to assess the physical properties of a novel resin-based endodontic sealer, Any-Seal, in comparison with AH Plus Jet. MATERIALS AND METHODS: Flow, radiopacity and compressive strength were examined according to ISO 6876/2001. For flow test, 0.05 mL of sealer was placed between glass plate and 100 g weight were applied. Ten minutes after mixing the sealers, the load was removed and the diameters of the compressed sealer discs were measured. For radiopacity, 10 mm diameter and 1 mm thickness sample were fabricated and took radiograph with an aluminum step-wedge and analyzed using imaging program. For compressive strength test, 4 mm × 6 mm cylindrical specimen was fabricated and tested after 24 hours and 1 week using Universal testing machine. RESULTS: Both tested sealers were consistent with ISO 6876/2001 in the flow and radiopacity test. The flow values of both sealers were not significantly different (P > 0.05). AH Plus Jet had significantly higher radiopacity (P < 0.05). AH Plus Jet showed higher compressive strength at both time intervals (P < 0.05). CONCLUSION: Any-Seal showed low compressive strength until after 1 week, so its physical and biological aspect should be evaluated more before clinical use.

Retreatability of two endodontic sealers, EndoSequence BC Sealer and AH Plus: a micro-computed tomographic comparison

OBJECTIVES: Recently, bioceramic sealers like EndoSequence BC Sealer (BC Sealer) have been introduced and are being used in endodontic practice. However, this sealer has limited research related to its retreatability. Hence, the aim of this study was to evaluate the retreatability of two sealers, BC Sealer as compared with AH Plus using micro-computed tomographic (micro-CT) analysis. MATERIALS AND METHODS: Fifty-six extracted human maxillary incisors were instrumented and randomly divided into 4 groups of 14 teeth: 1A, gutta-percha, AH Plus retreated with chloroform; 1B, gutta-percha, AH Plus retreated without chloroform; 2A, gutta-percha, EndoSequence BC Sealer retreated with chloroform; 2B, gutta-percha, EndoSequence BC Sealer retreated without chloroform. Micro-CT scans were taken before and after obturation and retreatment and analyzed for the volume of residual material. The specimens were longitudinally sectioned and digitized images were taken with the dental operating microscope. Data was analyzed using an ANOVA and a post-hoc Tukey test. Fisher exact tests were performed to analyze the ability to regain patency. RESULTS: There was significantly less residual root canal filling material in the AH Plus groups retreated with chloroform as compared to the others. The BC Sealer samples retreated with chloroform had better results than those retreated without chloroform. Furthermore, patency could be re-established in only 14% of teeth in the BC Sealer without chloroform group. CONCLUSION: The results of this study demonstrate that the BC Sealer group had significantly more residual filling material than the AH Plus group regardless of whether or not both sealers were retreated with chloroform.

Post space preparation timing of root canals sealed with AH Plus sealer

OBJECTIVES: To determine the optimal timing for post space preparation of root canals sealed with epoxy resin-based AH Plus sealer in terms of its polymerization and influence on apical leakage. MATERIALS AND METHODS: The epoxy polymerization of AH Plus (Dentsply DeTrey) as a function of time after mixing (8, 24, and 72 hours, and 1 week) was evaluated using Fourier transform infrared (FTIR) spectroscopy and microhardness measurements. The change in the glass transition temperature (Tg ) of the material with time was also investigated using differential scanning calorimetry (DSC). Fifty extracted human single-rooted premolars were filled with gutta-percha and AH Plus, and randomly separated into five groups (n = 10) based on post space preparation timing (immediately after root canal obturation and 8, 24, and 72 hours, and 1 week after root canal obturation). The extent of apical leakage (mm) of the five groups was compared using a dye leakage test. Each dataset was statistically analyzed by one-way analysis of variance and Tukey's post hoc test (α = 0.05). RESULTS: Continuous epoxy polymerization of the material with time was observed. Although the T(g) values of the material gradually increased with time, the specimens presented no clear T(g) value at 1 week after mixing. When the post space was prepared 1 week after root canal obturation, the leakage was significantly higher than in the other groups (p < 0.05), among which there was no significant difference in leakage. CONCLUSIONS: Poor apical seal was detected when post space preparation was delayed until 1 week after root canal obturation.

Long-Term Cytotoxicity, pH and Dissolution Rate of AH Plus and MTA Fillapex

Abstract The aim of the present study was to verify the long-term cytotoxic effects of the MTA Fillapex and to compare them with AH Plus. Dissolution rate and pH were also evaluated. Human osteoblast cells were incubated with elutes of fresh specimens from AH Plus and MTA Fillapex, and with elutes of the same specimens for 4 successive weeks. Elute's pH was evaluated at each time point. A multiparametric cell viability assay was performed. For dissolution rate, ISO methodology was used. The results were analyzed by one-way analysis of variance, complemented with the Tukey post-test (p<0.05). No significant difference was found among the materials when fresh mixed (p>0.05). After 1 week, AH Plus became non-cytotoxic on all three evaluated parameters. Conversely, MTA Fillapex remained severely and mildly cytotoxic over the entire experimental period (p<0.05). The dissolution rate of AH Plus was significantly lower than MTA Fillapex at all time points (p>0.05). The pH of AH Plus was significantly lower than MTA Fillapex at the second and third week (p<0.05). In the other tested time points no statistical difference was observed. In conclusion, MTA Fillapex remained cytotoxic after 4 weeks and its cytotoxicity may be related to the high dissolution rate of this material.

Resumo O objetivo do presente estudo foi verificar os efeitos citotóxicos de longo prazo da MTA Fillapex e comparar com os do AH Plus. Solubilidade e pH também foram avaliados. Osteoblastos humanos foram incubados com elutos de amostras frescas de AH Plus e MTA Fillapex, e com elutos dos mesmos espécimes pelas 4 semanas seguintes. O pH foi avaliado a cada semana. Um ensaio multiparamétrico de viabilidade celular foi realizado. Para solubilidade foi utilizada metodologia ISO. Os resultados foram analisados por ANOVA, complementada com o pós-teste de Tukey (p<0,05). Nenhuma diferença significativa foi encontrada entre os materiais frescos quando avaliados em relação a citotoxicidade (p>0,05). Depois de uma semana, o AH Plus tornou-se não-citotóxico em todos os três parâmetros avaliados. Por outro lado, MTA Fillapex permaneceu citotóxico durante todo o período experimental (p<0,05). A solubilidade do AH Plus foi significativamente menor do MTA Fillapex para todos os períodos avaliados (p>0,05). O pH da AH Plus foi significativamente menor do que o MTA Fillapex na segunda e na terceira semana (p<0,05). Nos outros períodos testados não houve diferença estatística. Em conclusão, o MTA Fillapex permaneceu citotóxico após 4 semanas e a sua citotoxicidade pode estar relacionada à elevada solubilidade deste material.

The effects of different final irrigation regimens on the bond strength of sealers to root canal walls / 实用口腔医学杂志

Objective:To evaluate the bond strength of root canal sealer AH Plus and GuttaFlow to root canal walls after final rinse with 4 different final irrigation regimens.Methods:60 teeth with single-canal were prepared chemomechanically using 5.25% sodi-um hypochlorite (NaOCl)as root canal irrigant.The teeth were then randomly distributed into 3 groups(n =20)according to the final irrigation protocol:1 7% EDTA followed by 2% chlorhexidine(CHX)(group 1 ),5.25% NaOCl followed by 1 7% EDTA(group 2), 0.9% normal saline(NS)(group 3).The root canals were then filled with sealers using a lentulo spiral and each group was distribu-ted into 2 subgroups according to the sealers(n =1 0):a.AH Plus;b.GuttaFlow.The roots were transversally sectioned to obtain 2mm thick dentinal slices.Then a push-out bond strength test was carried out and failure mode was observed by stereomicroscope. Results:The bond strength of AH Plus was significantly higher than that of GuttaFlow(P 0.05).When the root canals were filled with GuttaFlow,the push-out strength of group 1 ,2 and 3 was (1 .40 ±0.59)MPa, (1 .26 ±0.62)MPa and (1 .05 ±0.27)MPa respectively(P >0.05).The failure modes of AH Plus and GuttaFlow were both mainly mixed,but the proportion of adhesive failure in the canals filled with GuttaFlow were obviously higher than AH Plus.Conclusion:The bond strength to root canal wall of GuttaFlow is significantly lower than that of AH Plus.1 7% EDTA followed by 2% CHX as fi-nal irrigant can reduce the bond strength of AH Plus but has no marked effect on GuttaFlow.

To Compare the Pursuance of Ultrasonic Activation at Distinct Planes of Endodontic Therapy on Filling Superiority of Different Root Canal Sealers.

Aim: The purpose of this study was to evaluate the influence of ultrasonic activation at different levels of endodontic therapy on filling quality of various sealers. Materials and Methods: Sixty extracted human single rooted teeth were divided into 4 groups (n=15) based on the sealer used to obturate the root canal instrumented up to F4 pro taper. These groups were subsequently divided into 3 sub-groups (n=5) each depending on the activation protocol followed in the study (i.e., no activation of irrigant /sealer, activation of final irrigant, activation of both irrigant and sealer). All samples were sectioned at 2, 4, 6 mm from apex. The percentage of sealer penetration of root canals were analysed. Results: In the groups where the final irrigant and sealer was ultrasonically agitated showed statistically significant increase in sealer penetration when compared to other groups. I Root SP (D) showed a statistically significant difference in sealer penetration when compared to ZOE, AH plus and HRS. Conclusion: The tubular penetration depth varies with the different physical and chemical properties of the sealers used. The use of ultrasonic activation at different levels of endodontic therapy facilitated better dentinal sealer penetration with I Root SP and AH Plus. I Root SP has solely satisfied and surpassed the test of better sealer penetration even at the apical level.

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.

Sealing ability of two commonly used root canal sealers with and without smear layer

AIM: The aim of current research was to find out the sealing ability of two commonly used sealers in the presence and absence of smear layer at different time interval. MATERIAL AND METHODS: Total of 180 single rooted vital teeth were used. Transversal section was made with the help of digital slow speed cutting saw to divide the root and crown part. After removal of crown roots part was instrumented and prepared. The 180 teeth were randomly divided into two equal groups (n=90) 1 and 2. In group 1 the smear layer was kept intact but it was removed from group 2 with EDTA (17%). Group 1 was then divided into two sub-groups, A1, A2. Group 2 was again separated into two sub-groups, B1 and B2. Each sub-group contained of 45 samples. In sub-groups A1 and B1, AH Plus sealer, in sub-groups A2 and B2, Ketac-endo sealer and cold lateral condensation technique was used for obturation with gutta percha. All samples were kept in an incubator at 37°C for 24 hours, with help of nail polish/varnish all samples root surfaces was painted only excluding apical area after words each sub group were further divided in to three groups of 15 to represent immersion periods of 7,15 and 30 days. All samples were then kept in 5 % methylene blue dye solution at 37o c for their respective time periods. After specific time period, the roots of every group were cut longitudinally and evaluate under a stereomicroscopes to evaluate apical micro leakage in millimeter. Data was subjected to Repeated measure ANOVA with post-hoc analysis using Tukey and bonferroni tests. RESULTS: Overall analysis indicated significant reduction in sealing ability canals in with and without smear layer over different time periods (p <0.0001). CONCLUSION: Current study has concluded that AH plus sealer provides significantly better seal in the absence of smear layer than in the presence of smear layer in addition it gave better seal than Ketac-Endo sealer in the absence and presence of smear layer.