Influence of bioceramic sealer residues on the adhesion interface with a universal adhesive in the etch-and-rinse strategy, based on the application protocol and evaluation time.

The aim of this study was to evaluate the effects of the application of universal adhesive in the etch-and-rinse (ER) strategy with a manual brush (MB) or rotary brush (RB) in adhesion to dentin impregnated (WB) or not (NB) with bioceramic sealer, at 24 h and 1 year. Eighty-eight crowns of bovine incisors were divided into four groups (n=22): WB-MB, WB-RB, NB-MB, NB-RB. After the restorative protocol, dentin penetrability was evaluated by confocal microscopy. Bond strength was evaluated by microtensile test. Data were analyzed using one-way ANOVA/Tukey tests (α=0.05). NB-RB and WB-RB exhibited greater extensions of resin tags in dentin. At 24 h, WB-RB and NB-MB showed the highest and lowest values of bond strength, respectively. At 1 year, WB-MB and WB-RB demonstrated the highest bond strength values. The RB increases the formation of resin tags and residues of bioceramic sealer provides higher bond strength in the ER strategy.

Post-operative pain after single-visit root canal treatment using resin-based and bioceramic sealers in teeth with apical periodontitis: A randomised controlled-trial.

The present study aimed to compare postoperative pain in teeth with symptomatic and asymptomatic apical periodontitis (AP) following a single-visit endodontic treatment using BioRoot™ RCS or AH Plus at 8 h, 24 h and 48 h postoperatively. Postgraduate students performed endodontic treatment on 101 teeth with AP, randomised into two obturation groups. A 100-mm Visual Analog Scale was used to document the intensity of pain at preoperative, 8-h, 24-h and 48-h intervals. The Kolmogorov-Smirnov test was used for normality, and the median and interquartile ranges were compared using the Mann-Whitney U test. Preoperative pain (1.90 ± 3.50) was more frequent in teeth with symptomatic AP (p < 0.05). However, no significant differences were observed in postoperative pain at the 8-h, 24-h and 48-h intervals. Pre and postoperative pain were directly associated (p < 0.05). Single-visit root canal treatment in teeth with AP using both sealers resulted in similar levels of postoperative pain.

Comparación de la microfiltración apical de cuatro tipos de cementos endodónticos: Endofill, mtaFillapex, Adseal y Roeko Seal / Comparison of the Apical Microleakage of Four Types Of Endodontic Cements: Endofill, mta Fillapex, Adseal and Roeko Seal / Comparação da microinfiltração apical de quatro tipos de cimentos endodônticos: Endofill, mta Fillapex, Adseal e Roeko seal

Introducción: La microfiltración apical es uno de los principales causantes de fracasos endodónticos donde hay invasión de bacterias y líquidos periapicales a la parte interna del conducto radicular y material de relleno. Materiales y Métodos: La muestra estuvo conformada por 60 dientes premolares unirradiculares que fueron seccionados en la unión amelocementaria, la instrumentación biomecánica se realizó con técnica rotatoria e irrigación con hipoclorito de sodio al 5.25% y EDTA 17%, se dividió aleatoriamente en 4 grupos (n=15) para cada tipo de cemento, la obturación se realizó con la técnica de condensación lateral, a nivel coronal se obturó con Ionómero vidrio base y resina, se colocaron en una incubadora a 37° sumergidos en NaCL 0.9% por 5 días hasta el fraguado de los cementos, para observar la microfiltración se utilizó el método filtración de tinta china y la diafanización con la técnica de Robertson. Las medidas de microfiltración apical se observaron utilizando el Estereomicroscopio. Resultados: El valor promedio fue menor para el cemento Adseal 0,33mm, seguido por los cementos Fillapex 0,87mm, Roeko seal 1,00mm y Endofill 1,30mm respectivamente. Hubo diferencias estadísticamente significativas en la microfiltración apical de los cuatro cementos endodónticos (p=0.00) Conclusiones: El cemento Adseal presentó menor microfiltración en comparación a los cementos Fillapex, Roeko seal y Endofill.

Introduction: Apical microleakage is one of the main causes of endodontic failure, either due to invasion of microorganisms or periapical fluids into the canal, and only the composition of the type of obturator cement favors its reduction. The objective of this research was to compare the apical microleakage of four types of endodontic cements Endofill, MTA Fillapex, Adseal and Roeko Seal. Materials and methods: The sample consisted of 60 single root premolar teeth that were sectioned at the cement- enamel junction, the biomechanical instrumentation was performed with a rotary technique and irrigation with sodium hypochlorite and edta, randomly divided into 4 groups (n = 15) for each type of cement, the obturation was performed with the lateral condensation technique, at the coronal level it was obturated with base glass ionomer and resin, they were placed in an incubator at 37° submerged in NaCL 0.9% for 5 days until setting. of the cements, to observe the microleakage the India ink filtration method was used and diaph-anization with the Robertson technique. Apical microleakage measurements were observed using the Stereomicroscope. Results: The average value was lower for the Adseal 0.33 mm cement, followed by the Fillapex 0.87 mm, Roeko Seal 1.00 mm and Endofill 1.30 mm cements respectively. There were sta-tistically significant differences in the apical microleakage of the four endodontic cements (p = 0.00) Conclusions: Adseal cement presented less microfiltration compared to Fillapex, Roeko Seal and Endofill cements

Introdução: a microinfiltração apical é uma das principais causas de falhas endodônticas onde há inva-são de microrganismos e líquidos periapicais ao interior do conducto e só a composição do tipo de cimento obturador favorece sua disminuição. O objetivo desta pesquisa foi comparar a microinfiltração apical de quatro tipos de cimentos endodônticos Endofill, MTA Fillapex, Adseal e Roeko Seal. Materiais e métodos: a amostra foi composta por 60 dentes pré-molares uniradiculares que foram seccionados na junção amelocementária. A instrumentação biomecânica foi realizada com técnica rotatória e irrigação com hipoclorito e edta, sendo dividida aleatoriamente em 4 grupos (n = 15) para cada tipo de cimento. A obturação foi realizada pela técnica de condensação lateral, no nível coronal foi obturado com base de ionômero de vidro e resina, foram colocados em incubadora a 37° submersos em NaCl 0,9% por 5 dias até a pega dos cimentos. Para observar a microfiltração utilizou-se o método de filtração em tinta nan-quim e diafanização pela técnica de Robertson. As medidas de microinfiltração apical foram observadas utilizando o estereomicroscópio. Resultados: o valor médio foi menor para o cimento Adseal (0,33 mm), seguido pelos cimentos Fillapex (0,87 mm), Roeko Seal (1,00 mm) e Endofill (1,30 mm), respectivamente. Houve diferenças estatisticamente significativas na microinfiltração apical dos quatro cimentos endo-dônticos (p = 0,00). Conclusões: o cimento Adseal apresentou menor microinfiltração comparado aos cimentos Fillapex, Roeko seal e Endofill.

Premixed calcium silicate-based root canal sealers have better biological properties than AH Plus: A systematic review and meta-analysis of in vivo animal studies and in vitro laboratory studies.

Objectives: The aim was to determine whether premixed calcium silicate-based root canal sealers have better biological properties than AH Plus. Materials and Methods: Searches of studies published up to January 2023 were performed in the PubMed/MEDLINE and EMBASE and via other methods (databases of the International Endodontic Journal, Journal of Endodontics, and gray literature). The inclusion criteria were in vivo animal and in vitro studies that analyzed the response in the dorsal subcutaneous tissue of rats, cell viability, and genotoxicity. Systematic Review Centre for Laboratory Animal Experimentation Risk of Bias (RoB) tool for in vivo studies and modified CONSORT checklist for in vitro were appraised. Meta-analysis was performed using the Stata. Results: Fifty-two studies were included. In the RoB, in vivo studies fulfilled 20%-50% of the items and in vitro 60%-100%. The studies included in the meta-analysis demonstrated better histocompatibility with the premixed calcium silicate-based sealers at 30 days and greater cell viability with these sealers when used in undiluted extracts in experimental period of 72 h and in extracts with 1:2 and 1:4 dilution in 24 and 72 h. In contrast, no difference between materials was found concerning genotoxicity. Conclusion: Premixed calcium silicate-based root canal sealers have better histocompatibility and are less cytotoxic than the epoxy resin-based sealer AH Plus, demonstrating favorable biological behavior.

Evaluation of calcium hydroxide root canal filling materials by cone beam computed tomography and three-dimensional modeling.

AIM: The aim of this study was to compare the effectiveness of filling pastes in resin prototype primary molars by cone beam computed tomography (CBCT) and 3D modeling.

Comparison of the Antibacterial Effect of AH26, Adseal and Beta RCS Root Canal Sealers against Enterococcus Faecalis, an in Vitro Study.

Objectives: Antibacterial activity against endodontic pathogens is a desirable feature for root canal sealers. The objective of this study was to compare the antibacterial effect of three resin-based endodontic sealers (AH26, Adseal, and Beta RCS) against Enterococcus faecalis in vitro. Materials and Methods: The antibacterial properties of the sealers were assessed against E. faecalis using agar diffusion test (ADT) for fresh state (N=10) and direct contact test (DCT) for freshly-mixed and set states of the materials (N=10). In ADT, the diameter of the zones of inhibition was measured after 24h of contact. In DCT, the colony-forming units of the bacteria were counted after 30 minutes and 180 minutes of exposure. The results were analyzed with two-way ANOVA and independent sample t-test. P<0.05 was considered significant. Results: Regarding DCT results, all test materials indicated an antibacterial effect, both in freshly-mixed and set states. The highest antibacterial effect was related to Adseal, whereas the lowest was observed in Beta RCS. There was a significant difference between all study groups (different sealers, setting states, and contact times; P<0.001), except for freshly-mixed AH26 and Adseal at 180 minutes (P>0.05). According to ADT, AH26 and Adseal represented the widest and the smallest inhibition zones, respectively (P<0.001). Conclusion: Within the limitations of this in vitro study, AH26, Adseal, and Beta RCS showed antibacterial effects against E. faecalis in both freshly-mixed and set states. The antibacterial effect increased over time in all of the studied sealers.

Effect of the timing of primary endodontic treatment and dosage of radiation therapy on the filling material removal.

This study investigated the effect of the timing of primary endodontic treatment and dosage of radiotherapy on the remaining filling material (RFM) during endodontic reintervention. 60 single-rooted human mandibular premolars were distributed into five groups (n = 12), according to the timing and dosage of radiation (55Gy or 70Gy): NegativeCG-non-irradiated teeth; Endo-pre-RT55/70-obturation before irradiation (55Gy or 70Gy); Endo-post-RT55/70-obturation and reintervention after irradiation (55Gy or 70Gy). Roots were cleaved and analysed under stereomicroscope and Scanning Electron Microscope to quantify (%) the RFM. Experimental groups had a significantly greater amount (p < 0.05) of RFM in the middle and apical thirds than the control group, except for Endo-pre-RT55 in the middle third (p < 0.0001). The apical third had greater amount of RFM (p < 0.05). Radiation therapy, before and after primary endodontic treatment, increased the amount of RFM, regardless of the dose delivered. When necessary, reintervention preferably must be performed before radiation therapy.

Epoxy resin-based root canal sealers: An integrative literature review.

The correct obturation of the root canal system achieved by means of a core and a cement is essential for the success of endodontic treatment. There are several root canal cements (RCCs) on the market; however, because of their excellent characteristics, epoxy resin-based sealers (ERBSs) have been widely used. The main aim of this review was to analyze and integrate the available information on different ERBSs. An electronic search was performed in the PubMed and Scopus databases, using "epoxy resin" AND "root canal treatment", and "epoxy resin" AND "endodontics" as search terms. In general, ERBSs have good flow properties, film thickness, solubility, dimensional stability, sealing capacity, and radiopacity. They are also able to adhere to dentin while exhibiting low toxicity and some antibacterial effects. However, their main disadvantage is the lack of bioactivity and biomineralization capability. A large number of ERBSs are available on the market, and AH Plus keeps being the gold standard RCC. Yet, information on many of them is limited or non-existent, which could be due to the fact that some of them are relatively new. The latter emphasizes the need for relevant research on the physicochemical and biological properties of some ERBSs, with the aim of supporting their clinical use with sufficient evidence via prospective and long-term studies.

Comparative evaluation of resin-based sealers and bioceramic sealers for postoperative pain after endodontic treatment: A systematic review.

The systematic review aimed to compare and evaluate the effect of resin-based sealers and bioceramic sealers on postoperative pain after endodontic treatment. Two reviewers independently conducted electronic search in PubMed, the Web of Science, ScienceDirect, the Wiley Online Library, SpringerLink, Google Scholar, and the Cochrane Library, employing a complete dual-review process to ensure the inclusion of all relevant studies in the review. The search was carried out until November 2021. After selecting eligible studies, the risk of bias assessment was carried out using the revised Cochrane risk-ofbias tool for randomized trials (RoB 2). A total of 1,931 studies were identified from the electronic search, and finally 10 studies were included after full-text assessment. In all our included studies, the visual analog scale (VAS) was used for recording pain scores. Most of the studies recorded pain intensity starting from 6 h to 7 days. The results showed that there was no significant difference between resin-based sealers and bioceramic sealers in terms of incidence or intensity of postoperative pain at any point in time.

Heat-Induced Changes in the Physical Properties of a New Premixed Calcium Silicate-Containing Root Canal Sealer: An In Vitro Study.

This study aimed to examine how heating affects the physical properties of a newly developed premixed calcium silicate-containing sealer (AH Plus Bioceramic Sealer; AHB), in comparison with EndoSequence BC Sealer (ES), AH Plus Jet (AH), and Pulp Canal Sealer. The setting time, flow, and film thickness were tested with or without heating at 100 °C for 30 or 60 s, in accordance with ISO6876:2012 standards. Ultrastructural and elemental analyses were performed with scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). Data were analyzed using one-way analysis of variance (ANOVA) with a Tukey post hoc test (α = 0.05). All sealers exhibited significantly shorter setting time and flow after heating at 100 °C for 30 and 60 s (p < 0.05). After heating, AHB showed a significantly higher film thickness compared to that of the other materials (p < 0.05). None of the tested properties of heat-applied AHB and ES met ISO standards, except the setting time in ES. The SEM/EDS results for AHB and ES were not affected by heating. The detected changes in physical properties can negatively impact the performance of premixed calcium silicate-containing sealers, particularly AHB, when warm vertical compaction is employed.

Root canal dentin wear during final irrigation in endodontic retreatment with passive ultrasonic irrigation and easy clean instruments.

Context: Complementary procedures have been proposed to improve the endodontic retreatments. Aim: The aim of this study was to evaluate, by microcomputed tomography (micro-CT), the dentin wear caused by passive ultrasonic irrigation (PUI) and easy clean (EC) instruments, when used for the final removal of filling material during endodontic retreatment. Methods: Thirty-six mesial roots of the lower first molars were divided into four groups (n = 9), according to the final irrigation and sealer: PUI/AH Plus, EC/AH Plus, PUI/Total Fill (TF), and EC/TF. Canal volume was evaluated, both before and after the final irrigation, by micro-CT analysis. The Kruskal-Wallis test was used to compare the volumes among groups and the paired Wilcoxon test was used to compare the volume values before and after the final irrigation within each group. Results: Both complementary cleaning procedures promoted dentin wear that was observed only when the volume was analyzed for each third of the root canal. In the apical third, both instruments showed significant wear, where the use of the EC instrument resulted in greater wear than the PUI, in teeth filled with both AH Plus and TF BC Sealers (P < 0.05). Conclusion: Both complementary cleaning procedures promoted dentin wear and must be used cautiously.

Morphometric parameters of dental pulp in immature teeth in a sheep model after mechanical pulp exposure and restoration with reinforced zinc oxide-eugenol.

Background: The aim of the study was to investigate the morphometric parameters of dental pulp in open apices immature teeth in a sheep model after mechanical pulp exposure and restoration with reinforced zinc oxide-eugenol. Materials and Methods: In this experimental study, a total of 12 immature mandibular central incisors from six adult male sheep, weighing 30-40 kg and with the age of 1 year old with Merino race were examined. After anesthesia, the pulps of the teeth in the case group were mechanically exposed and then were restored with reinforced zinc oxide-eugenol and amalgam. In the control group, the teeth remained intact. The animals were sacrificed at intervals of 2, 4, 6, and 8 weeks (E2, E4, E6, and E8) in the case and 2 and 8 weeks (C2 and C8) in the control groups. Then, their teeth were removed with the surrounding supporting tissues and alveolar bones. Tissue processing and staining were done, and the sections were examined under a light microscope. The Kruskal-Wallis and Mann-Whitney U tests were used to analyze the data and compare the changes between the two groups. P < 0.05 was considered statistically significant. Results: In response to mechanical exposure, reparative or tertiary dentin was formed, and its thickness increased during the time of the study. The thickness of the odontoblastic layer in the E4 group was the highest amount. The pulp chamber diameter in the C2 group was significantly larger than the other groups, and the diameter of the apical foramen in the E8 was decreased significantly compared to the controls (P < 0.05). Conclusion: In response to mechanical exposure and restoration with reinforced zinc oxide-eugenol, some morphometric parameters of the dental pulp changed significantly in the sheep model compared to the controls.

A case of surgical treatment for bronchial foreign bodies with obstructive pneumonia.

Children and older adults are prone to unintentional foreign body aspiration. A 69-year-old man with fever and anorexia presented with obstructive pneumonia resulting from foreign body aspiration. Attempts to remove the foreign body using a bronchoscope failed due to its adhesion to the periphery of the bronchus. Although antibiotic therapy did not improve the obstructive pneumonia caused by the bronchial foreign body, surgery enabled an improvement. The surgical specimen showed similar pathological findings as the fine brown granular material observed in root granulomas occurring as a complication following leakage of root canal filling used in the treatment of dental caries. Therefore, the bronchial foreign body may have been a dental filling. Case reports describing surgical improvement of difficult-to-remove bronchial foreign bodies with concurrent infection are rare.

In silico toxicity and immunological interactions of components of calcium silicate-based and epoxy resin-based endodontic sealers.

OBJECTIVES: The present study aimed to determine in silico toxicity predictions of test compounds from hydraulic calcium silicate-based sealers (HCSBS) and AH Plus and computationally simulate the interaction between these substances and mediators of periapical inflammation via molecular docking. MATERIALS AND METHODS: All chemical information of the test compounds was obtained from the PubChem site. Predictions for bioavailability and toxicity analyses were determined by the Molinspiration Cheminformatics, pkCSM, ProTox-II and OSIRIS Property Explorer platforms. Molecular docking was performed using the Autodock4 AMDock v.1.5.2 program to analyse interactions between proteins (IL-1ß, IL-6, IL-8, IL-10 and TNF-α) and ligands (calcium silicate hydrate, zirconium oxide, bisphenol-A epoxy resin, dibenzylamine, iron oxide and calcium tungstate) to establish the affinity and bonding mode between systems. RESULTS: Bisphenol-A epoxy resin had the lowest maximum dose tolerated in humans and was the test compound with the largest number of toxicological properties (hepatotoxicity, carcinogenicity and irritant). All systems had favourable molecular docking. However, the ligands bisphenol-A epoxy resin and dibenzylamine had the greatest affinity with the cytokines tested. CONCLUSION: In silico predictions and molecular docking pointed the higher toxicity and greater interaction with mediators of periapical inflammation of the main test compounds from AH Plus compared to those from HCSBS. CLINICAL RELEVANCE: This is the first in silico study involving endodontic materials and may serve as the basis for further research that can generate more data, producing knowledge on the interference of each chemical compound in the composition of different root canal sealers.

Analysis of the cytotoxicity and bioactivity of CeraSeal, BioRoot™ and AH Plus® sealers in pre-osteoblast lineage cells.

BACKGROUND: The objective of the present study was to evaluate in vitro the cytotoxicity and bioactivity of various endodontic sealers (CeraSeal, BioRoot™ and AH Plus®) in pre-osteoblast mouse cells (MC3T3 cells). METHODS: MC3T3 cells (ATCC CRL-2594) were plated in 1 × 104 cells/well in 96-well plates in contact with endodontic sealers at concentrations of 1:10 and 1:100. Cell viability was evaluated by MTT assay after 24 and 48 h. In addition, sealer bioactivity was measured by RT-PCR for mediator of inflammation (Tnf, Ptgs2) and mineralization (Runx2, Msx1, Ssp1 and Dmp1) after 24 h and by Alizarin Red S Assay of mineralization after 28 days. Data were analyzed using one-way ANOVA followed by the Tukey's post-test at a significance level of 5%. RESULTS: BioRoot™ presented 24-hour cytotoxicity (p < 0.05) at 1:10 concentration. In the period of 48 h, no endodontic cement was cytotoxic to the cells compared to the control (p > 0.05). TNF-α gene expression was induced by AH Plus® (p < 0.05), while Ptgs2 was induced by the CeraSeal and BioRoot™ (p < 0.05). The expression of Runx2 was stimulated by BioRoot™ and AH Plus® (p < 0.05). In contrast, the expression of Dmp-1 Dmp1 was higher for the CeraSeal and BioRoot™ (p < 0.05). Nonetheless, the sealers did not impact the formation of mineralization nodules (p > 0.05). CONCLUSION: CeraSeal, BioRoot™ and AH Plus® sealers were not cytotoxic to MC3T3 cells within 48 h, but differentially induced the expression of genes related to inflammation and mineralization without impacting biomineralization by the cells.

[Sealing effect of GuttaFlow2 in curved root canals].

OBJECTIVE: To evaluate the sealing ability of GuttaFlow2 single cone obturation in curved root canals. METHODS: (1) Slight, moderate and severe curved 3D printed root canals were made. After instrumentation, these samples were randomly divided into 2 groups (n = 10) according to different root canal filling techniques: GuttaFlow2 single cone group (GF2) and AH-Plus warm vertical compation group (WVC). All the samples were sectioned at 2 mm to apex (the apical of the root), 4 mm, 6 mm to apex (the middle of the root) and 8 mm to apex (the coronal of the root). The filling void areas were observed by stereomicroscope, and the percentages of void areas in each section were calculated by ImageJ 1.52a. (2) Forty-eight roots of extracted adult molars were selected. After instrumentation, they were randomly divided into 2 groups (n = 8): GF2 group and WVC group. Before root canal filling, the sea-lers were mixed with Rhodamine B dye for visualization under confocal laser scanning microscope. All samples were sectioned at 2 mm to apex (the apical of the root), 5 mm to apex (the middle of the root) and 8 mm to apex(the coronal of the root). Then, the percentages of sealer penetration into dentinal tubules in each section were calculated. RESULTS: At the apical of the root, there were no obvious voids in slight, moderate and severe curved canals in the GF2 group and the WVC group. There was no significant difference between the two groups (P > 0.05). At the middle of the root, there was no significant difference in the percentages of void areas between the two filling methods, but at the coronal of the root, there were more voids in the slight curved root canal in the GF2 group than in the WVC group, and the difference was significant (P = 0.009). The percentages of sealer penetration into dentinal tubules of slight, moderate and severe curved root canals in the GF2 group were 36.10%, 55.80%, 65.08%, respectively. And they were all higher than those in the WVC group (15.78%, 20.70%, 15.61%), respectively, the difference between the two groups was significant (P = 0.001). At the middle of the root, the percentages of sealer penetration into dentinal tubules of slight and moderate curved root canals in GF2 group were also significantly higher than those in the WVC group (P = 0.001). At the coronal of the root, there was no significant difference between the two groups (P > 0.05). CONCLUSION: GuttaFlow2 filling technique has the same sealing effect on the root canal at the apical and middle of the root as the warm vertical technique, but has a better sealing effect on the dentin tubules, especially for severe curved root canal.

Enhancing Coronal Adaptation of Root Canal Fillings with a Modified Single-Cone Obturation Technique: Two Case Reports.

The single-cone technique, also known as the hydraulic condensation technique, is widely employed in endodontics. However, the aforementioned method is presented with certain limitations; specifically concerning the coronal seal and the adaptation of the coronal third of a master gutta-percha (GP) with a round cross-section to the coronal dentinal walls of root canals with semi-round or oval cross-sections. Through two case reports, the current article introduces the coronal vertical condensation (CVC) technique; aiming to enhance GP adaptation to canal walls in similar scenarios. In fact, the coronal vertical condensation technique amalgamates the different aspects of warm vertical condensation and single-cone techniques. In CVC, following the placement of the master GP cone, an electrical heat carrier is inserted immediately a few millimeters apical from the canal orifice to remove the coronal portion of the master GP cone. Subsequently, a hand plugger is used to condense GP in the vertical dimension, and the coronal space is backfilled using melted GP. The implementation of CVC technique has demonstrated an improved coronal adaptation of GP with canal walls. The stated technique seems beneficial; especially in the obturation of severely curved canals or root canals with a final preparation shape of variable taper.

Can the addition of surfactants to NaOCl irrigation impact on the percentage of voids of root canal filling?

This study evaluated the impact of canal irrigation using surfactants associated to NaOCl on the percentage of voids of root canal filling through micro-computed tomographic (micro-CT) analysis. 27 mandibular mesial roots with Vertucci type II canal configuration with isthmus were selected and scanned in a micro-CT device. The specimens were assigned to three groups (n = 9), according to the irrigation solution during instrumentation: 2.5% NaOCl without additives (control), 2.5% NaOCl with 0.1% Benzalkonium Chloride and 2.5% NaOCl with 0.1% Tween 80. After obturation, the specimens were rescanned, and the percentage of voids were calculated. Data were analysed using one-way ANOVA with a significance level of 5%. The percentage of voids were similar among the groups (p > 0.05). None of the specimens showed completely voids-free areas. The addition of surfactants to NaOCl irrigation did not improve the quality of root canal filling of mandibular mesial root canals.

Comparative in vitro analysis of the antifungal activity of different calcium silicate-based endodontic sealers

Aim: This study aimed to perform an in vitro comparative analysis of the antifungal activity of different calcium silicate-based endodontic sealers against three fungal species. Methods: The antifungal properties of three calcium silicate-based sealers were tested: Bio-C Sealer, Cambiar a Sealer Plus BC, and MTA-Fillapex. Two commonly used sealers were used as controls: AH Plus and Endomethasone. An agar diffusion test was performed to analyze the antifungal activity of the sealers against Candida albicans, Candida glabrata, Candida tropicalis, and a mixed microbial culture medium. The results were analyzed using ANOVA (p <0.05). Results: Endomethasone exhibited the highest inhibition against all strains examined, maintaining a consistent level of inhibition throughout 7 days. MTA-Fillapex demonstrated the best performance among the calcium silicate-based sealers for the three fungal species (p < 0.05), maintaining stable values over the 7 days, surpassing that of Endomethasone. Nevertheless, MTA-Fillapex only exhibited antimicrobial effect against the mixed culture for the first 24 hours, and no antimicrobial activity was observed at 48 hours, being surpassed by all tested sealers (p < 0.05). Conclusion: Of all silicate-based sealers tested, only MTA-Fillapex exhibited promising antifungal activity. Nevertheless, care must be taken when extrapolating these results, as MTA-Fillapex exhibited poor antimicrobial activity when tested in mixed microbial cultures

Continuous Wave of Condensation Improves the Filling of Curved Canals: a Micro-CT Study / La condensación de onda contínua mejora el selle de canales curvos: un estudio de micro-CT

Abstract The aim of this study was to compare the filling capacity in curved root canal using a new continuous wave of condensation technique (Termo Pack II, Easy Dental Equipments, Brazil) or lateral compaction. The percentage of voids in the filling of mesial root canals of mandibular molars was assessed by micro-computed tomography (micro-CT). Mesial root canals (n=24) of mandibular molars with a degree of curvature between 20° and 40° were prepared using rotary system (ProDesign Logic, Easy, Brazil) up to #35, .05 taper. The root canals were filled by using the continuous wave of condensation system or lateral compaction and AH Plus sealer (n=12). Scanning at 9 µm was performed after preparation and after filling by using micro-CT SkyScan 1176. The volumetric percentage of filling material and voids (total length and in each root canal third) were calculated. Data were analyzed using ANOVA/ Tukey and Student's t tests (α=0.05). Before the filling techniques, the root canals volume after preparation was similar (p>0.05). The root canals filled by the continuous wave of condensation technique presented the lowest percentage of voids, and the greatest percentage of filling material in total length and thirds (cervical, middle and apical) (p<0.05). Both techniques were not able of completely filling the root canals. The continuous wave of condensation technique Termo Pack II promoted better root canal filling in curved root canals, when compared with lateral compaction.

Resumen El objetivo de este estudio fue comparar la capacidad de obturación en conductos radiculares curvos utilizando una nueva técnica de condensación de onda continua (Termo Pack II, Easy Dental Equipments, Brasil) vs compactación lateral. El porcentaje de brechas en la obturación de los conductos radiculares mesiales de los molares mandibulares se evaluó mediante microtomografía computarizada (micro-CT). Se prepararon conductos radiculares mesiales (n=24) de molares mandibulares con un grado de curvatura entre 20° y 40° utilizando un sistema rotatorio (ProDesign Logic, Easy, Brasil) al #35, conicidad 0,05. Los conductos radiculares se obturaron utilizando un sistema de condensación de onda contínua o compactación lateral y cemento AH Plus (n=12). Se realizó un escaneo de 9 µm después de la preparación y después de la obturación usando el micro-CT SkyScan 1176. Se calculó el porcentaje volumétrico de material de obturación y vacíos (longitud total y en cada tercio del conducto radicular). Los datos se analizaron utilizando las pruebas ANOVA/Tukey y t de Student (α=0,05). Antes de las técnicas de obturación, el volumen de los conductos radiculares después de la preparación fue similar (p>0,05). Los conductos radiculares obturados con la técnica de condensación por onda contínua presentaron el menor porcentaje de vacíos y el mayor porcentaje de material de obturación en longitud total y en tercios (cervical, medio y apical) (p<0,05). Ambas técnicas no fueron capaces de llenar completamente los conductos radiculares. La técnica de condensación de onda contínua Termo Pack II promovió un mejor relleno del conducto radicular en conductos radiculares curvos en comparación con la compactación lateral.