Comparative Evaluation of the Apical Leakage of Different Bioceramic Retrofilling Materials with and without Smear Layer: A Stereomicroscopic Study

Objective: Present in?vitro study aimed to evaluate the apical leakage of different bioceramic retrofilling materials with and without smear layer. Materials and Methods: Sixty human single?rooted teeth were decoronated at a standardized root length of 13 mm, chemo?mechanically prepared and obturated. After obturation, root?end resection was done and root?end cavities were prepared using ultrasonic tips. The specimens with prepared retro cavities were randomly assigned into 2 groups (n = 30) based on the smear layer removal protocol used. Each group was further subdivided into 3 subgroups (n = 10) based on the bioceramic retrofilling material MTA (Mineral Trioxide Aggregate; Proroot Dentsply/Tulsa), CEM (Calcium?Enriched Mixture; Bionique Dent, Tehran) and ERRM (EndoSequence® Root Repair Material; Brasseler USA, Savannah, GA). The extension of dye (2% Rhodamine B) penetration was measured in millimetre using a stereomicroscope at 10× zoom. Results were statistically analysed using one?way ANOVA (analysis of variance) test and unpaired Student’s t test. Results: In the presence of smear layer, MTA demonstrated maximum mean apical leakage value (1.70 ± 0.30), followed by CEM (1.40 ± 0.37) and ERRM (1.40 ± 0.23), which was statistically not significant. Without the smear layer, ERRM demonstrated the least mean apical leakage value, which was statistically significant as compared with CEM (P <.05) and MTA ( P <.01). Conclusion(s): All bioceramic retrofilling materials demonstrated apical leakage irrespective of the presence or absence of the smear layer. The presence of a smear layer is beneficial for the sealing ab

Comparative Evaluation of Antimicrobial Efficacy of Mineral Trioxide Aggregate, Biodentine, EndoSequence against Bacterial Strains of Enterococcus faecalis- An In-Vitro Study.

Microorganisms are the common aetiological factors in initiation as well as perpetuation of periapical and pulpal diseases. Microbial leakage is a cardinal aetiology behind endodontic treatment failure. The success of root canal treatment is greatly influenced by antimicrobial potential of the dental material used in endodontic procedures which plays an important role in creating a hermetic seal to prevent egress of bacteria into root canal from periapical region. METHODSThe three cements MTA, Biodentine and EndoSequence were made into pellets to test their antimicrobial action on the growth of Enterococcus faecalis (ATCC 29212); method used was agar diffusion test. RESULTSAt 24-hour study interval, EndoSequence showed the greatest zone of inhibition of 10.6 mm against Enterococcus faecalis (ATCC 29212) compared to Biodentine with zone of inhibition of 5.5 mm and MTA with the zone of inhibition of 5 mm. EndoSequence showed highest antimicrobial efficacy at 36-hours and 72-hours study intervals by mean inhibition zone of 11 mm against Enterococcus faecalis compared to that of Biodentine (6 mm) and MTA (5.6 mm) respectively with a p value of less than 0.05 which is highly significant. The antimicrobial activity of EndoSequence was very strong compared to Biodentine and MTA against Enterococcus faecalis (ATCC 29212). CONCLUSIONSMicroorganisms play pivotal role in the initiation as well as perpetuation of periapical and pulpal diseases. Microbial leakage is a cardinal aetiology behind endodontic treatment failure. The success of the root canal treatment is greatly influenced by antimicrobial potential of the dental material used in endodontic procedures which plays an important role in creating a hermetic seal to prevent egress of bacteria into root canal from periapical region.

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.

In Vitro Cytotoxicity Evaluation of Three Root-End Filling Materials in Human Periodontal Ligament Fibroblasts

Abstract The aim of this study was to evaluate in vitro the cytotoxicity on human periodontal ligament fibroblasts of three root-end filling materials: MTA Angelus(r), EndoSequence Root Repair Material Putty(r) and Super EBA(r). A primary culture of human periodontal ligament fibroblasts was previously obtained in order to evaluate the cytotoxicity of the three extracts from the root-end filling materials after 2 and 7 days of setting. Serial dilutions of these extracts (1:1, 1:2, 1:4 and 1:8) were evaluated at 1, 3 and 7 days using the methyl-thiazol-tetrazolium (MTT) colorimetric assay. Cell viability was evaluated as percentage of the negative control group, which represented 100% cell viability. Statistical analyses were done with t-test, ANOVA and Kruskal-Wallis test at a significance level of 5%. It was found that the main difference among root-end filling materials was in the higher dilutions (p<0.05), but there was a similar behavior in lower dilutions (p>0.05). Cell viability of MTA Angelus(r) was superior for 2-day setting (p<0.05), compared with the other two root-end fillings. There were no statistically significant differences between 7-day set MTA Angelus(r) and EndoSequence Root Repair Material Putty(r). Super EBA(r) showed the lowest percentage of cell viability at higher dilutions (p<0.05). Therefore, MTA Angelus(r) and EndoSequence Root Repair Material Putty(r) were less cytotoxic in the highest dilution (1:1) compared with Super EBA(r).

Resumo O objetivo deste trabalho foi avaliar in vitro a citotoxicidade em fibroblastos do ligamento periodontal humano de três cimentos de retrobturação: MTA Angelus(r), EndoSequence Root Repair Material Putty(r) e Super EBA(r). Uma cultura de fibroblastos primários do ligamento periodontal humano foi obtida anteriormente a fim de avaliar a citotoxicidade dos três extratos dos cimentos de retrobturação após 2 e 7 dias de endurecimento. As diluições em série destes extratos (1:1, 1:2, 1:4 e 1:8) foram avaliados em 1, 3 e 7 dias empregando o ensaio colorimétrico metil-tiazol-tetrazólio (MTT). A viabilidade celular foi calculada em base da porcentagem do grupo de controle negativo, que representou 100% de viabilidade de células. As análises estatísticas foram realizadas com o teste t, ANOVA e teste de Kruskal-Wallis a um nível de significância de 5%. Verificou-se que a principal diferença entre os cimentos de retrobturação estava nas diluições mais elevadas (p<0,05) e houve um comportamento semelhante nas diluições mais baixas (p>0,05). A viabilidade celular dos fibroblastos do ligamento periodontal humano foi superior para MTA Angelus(r) de 2 dias de endurecimento (p<0,05), em comparação com os outros materiais de retrobturação. Não houve diferença significante entre MTA Angelus(r) e EndoSequence Root Repair Material Putty(r) de 7 dias de endurecimento. Super EBA(r) mostrou a menor percentagem da viabilidade celular nas diluições mais altas (p<0,05). Portanto, os cimentos de retrobturação MTA Angelus(r) e EndoSequence Root Repair Material Putty(r) foram menos citotóxicos na diluição mais alta (1:1) em comparação com Super EBA(r).

Endodontic Repair Filling Materials: A Review Article.

The emergence of Mineral Trioxide Aggregate (MTA) as endodontic repair filling material has generated a lot of interest due to its superior sealing ability and biocompatibility. Although MTA possesses superior sealing ability to traditional endodontic repair filling materials, such as calcium hydroxide, but it has poor handling characteristics. A novel endodontic repair filling materials with similar chemical composition, but improved handling characteristics, was recently developed. Recently, BioAggregate repair filling materials is claimed as biocompatible material and promotes cementogenesis and forms a hermetic seal inside the root canal. More recently, Biodentine and EndoSequence endodontic repair materials introduced to the market. Both materials have recommended for perforation repair, apical surgery, apical plug, and pulp capping. This article focused about physical properties of endodontic repair filling materials.