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Introduction: The technique of endodontic surgery had evolved tremendously in the recent years with introduction of new instruments and materials. Aim: This study aims to compare the clinical outcome of endodontic microsurgery using three different techniques with three different root-end filling materials for 16 months. Materials and Methods: A total of 45 maxillary incisors indicated for root-end surgery were selected for the study. They were enrolled into three groups, i.e. Group A (traditional [TRS]/heat burnished gutta-percha), Group B (concave [CON]/Retroplast), and Group C (cavity/DiaRoot BioAggregate), of 15 teeth each. The clinical and radiographic outcome was recorded at 1, 6, 12, and 16 months using various criteria. Statistical Analysis: The data were analyzed by one-way analysis of variance and Tukey's post hoc test using SPSS V. 21 software (IBM Corp., Somers, NY, USA). Results: All patients had uneventful healing at the final follow-up. Radiological intratime analysis concluded a highly high significant (P < 0.0001) decrease in the size of radiolucency between the three groups at the third recall visit. Intertime analysis recorded no significant decrease in radiolucency between Groups A and B, a significant decrease in B and C, and a highly significant decrease between Groups A and C at 12 months. Conclusions: There was no significant difference in the clinical outcome after endodontic surgery when comparing TRS/heat burnished gutta-percha, CON/Retroplast, and cavity/DiaRoot BioAggregate techniques at 16 months. However, cavity/DiaRoot BioAggregate resulted in significantly rapid and predictable healing at 12 months.
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Background/purpose: There is controversial evidence on the best choice for root-end filling materials in follow-up periods and treatment protocols. The purpose of this study was to evaluate the effectiveness of different root-end filling materials in modern surgical endodontic treatment. Materials and methods: A total of 16 studies with a minimum follow-up of 12-months were qualified to be reviewed, involving randomized control trials and observational studies in PubMed, Cochrane library and Scopus until September 1, 2021. The outcome of modern surgical endodontic treatment was assessed based on clinical and radiographic success. Direct comparisons were combined to estimate indirect comparisons, and the estimated effect size was analyzed using the odds ratio (OR). The comparative effectiveness of all materials for target outcomes were shown as P-score. Results: Within this network meta-analysis, mineral trioxide aggregate (MTA) had superior effects among all root-end filling materials at 12-months follow-up. (MTA: OR, 2.03; 95% CI, 0.84-4.91; P-score, 0.86; reference material, gutta-percha). In further sensitivity analyses, MTA, calcium silicate-based root repair material (RRM) and super EBA cement (Super EBA) were associated with significantly higher success rates at 12-months follow-up. (MTA: OR, 5.62; 95% CI, 1.58-19.99; P-score, 0.88; RRM: OR, 5.23; 95% CI, 1.05-25.98; P-score, 0.74; Super EBA: OR, 3.99; 95% CI, 1.06-15.04; P-score, 0.54; reference material, gutta-percha). Conclusion: MTA remains the best choice for root-end filling materials of modern surgical endodontic treatment at the 12-month follow-up. Comparative randomized clinical trials in the long-term follow-up are warranted in future investigations.
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Background/purpose: Regarding root-end filling materials in apical surgery, sealing ability and biocompatibility are useful for treatment. Angiogenesis, which occurs in the process of periapical wound healing, is closely related to bone formation. In this study, we investigated the effects of root-end filling materials on vascular endothelial cell proliferation and angiogenesis. Materials and methods: Mineral trioxide aggregate (MTA), 4-methacryloxyethyl trimellitate anhydride/methyl methacrylate-tri-n-butyl borane (4-META/MMA-TBB) resin, Super EBA, and CS-BG-multi, bioactive glass-related materials, were used. After curing, each material was soaked in a medium for 1 or 7 days, and then cultured for 1-7 days to investigate the effects on human umbilical vein endothelial cell (HUVEC) proliferation, angiogenesis, and vascular endothelial growth factor receptors (VEGFRs) mRNA expression. Results: In the 1-day soaked sample, there was significantly less proliferation in MTA and Super EBA on day 7 of culture. In the 7-day soaked sample, there was significantly less proliferation in Super EBA and CS-BG-multi on day 7 of culture. Tube formation was significantly high in MTA in both the 1-day and 7-day soaked samples, significantly high in SB in the 1-day soaked sample, and significantly low in Super EBA in both the 1-day and 7-day soaked samples. CS-BG-multi was comparable to the control. VEGFR-1 and VEGFR-2 mRNA expressions showed an upward trend in MTA, and a trend similar to the control in SB. Conclusion: MTA and 4-META/MMA-TBB resin had a higher pro-angiogenic effect while Super EBA had a less pro-angiogenic effect. CS-BG-multi had low toxicity on tube formation of HUVEC.
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PURPOSE: The aim of the present study was to evaluate the sealing performance, expressed as microleakage (ML), of two root-end filling materials when used at different retro-preparation lengths. METHODS: Fifty single-rooted human teeth were collected for the study. The teeth were cut at the cement-enamel junction and endodontic treatment was performed. Each root was cut at 3 mm from the apex and then stored in wet condition. The teeth were divided into three groups according to the retro-preparation length: control group (no retro-preparation); group 1 (retro-preparation of 3 mm); group 2 (retro-preparation of 9 mm). The teeth were equally allocated to either Biodentine or Super EBA treatment group. The teeth were immersed in 3% methylene blue dye solution for 24 h. The samples were split longitudinally and the depth of dye penetration was examined through light microscopy. RESULTS: No significant statistical differences were found at different retro-preparation lengths (P > 0.05). Differences were found between materials (P > 0.05). CONCLUSION: Biodentine showed significantly lower ML when compared to Super-EBA and no statistical significative differences were observed when samples were retro-prepared at 3 mm or 9 mm.
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Filtración Dental , Materiales de Obturación del Conducto Radicular , Compuestos de Aluminio , Cementos Dentales , Combinación de Medicamentos , Humanos , Óxidos , SilicatosRESUMEN
Commercial mineral trioxide aggregate (MTA) materials such as Endocem MTA (EC), Dia-Root Bio MTA (DR), RetroMTA (RM), and ProRoot MTA (PR) are increasingly used as root-end filling materials. The aim of this study was to assess and compare the physicochemical and mechanical properties and cytotoxicity of these MTAs. The film thicknesses of EC and DR were considerably less than that of PR; however, RM's film thickness was greater than that of PR. In addition, the setting times of EC, DR, and RM were shorter than that of PR (p < 0.05). The solubility was not significantly different among all groups. The three relatively new MTA groups (EC, DR, and RM) exhibited a significant difference in pH variation and calcium ion release relative to the PR group (p < 0.05). The radiopacity of the three new MTAs was considerably less than that of PR. The mechanical strength of RM was not significantly different from that of PR (p > 0.05); however, the EC and DR groups were not as strong as PR (p < 0.05). All MTA groups revealed cytocompatibility. In conclusion, the results of this study confirmed that EC, RM, DR, and PR exhibit clinically acceptable physicochemical and mechanical properties and cell cytotoxicity.
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BACKGROUND: The present study compares the apical microleakage of three different root-end filling materials in which the retrograde cavity is prepared by two different burs. METHODS: Eighty extracted single rooted maxillary and mandibular premolars were taken. Root canal treatment was completed. Apical 3 mm of all the teeth were resected with diamond disk. The tooth were divided into four groups with two subgroups for each group containing 10 tooth (N = 10) as: Group IA (Negative Control and IB (Positive Control); Group IIA and IIB: Prepared with round carbide bur and round diamond bur respectively, filled with GIC; Group IIIA and IIIB: Prepared with round carbide bur and round diamond bur respectively, filled with MTA; Group IVA and IVB: Prepared with round carbide bur and round diamond bur, filled with Biodentine. After applying two coats of nail varnish leaving apical 3 mm (except for negative control group) all teeth were immersed in 2% methylene blue for 3 days and again in 65% nitric acid for next 3 days for extraction of dye. The obtained solution was then transferred to eppendorf tube and centrifuged in microcentrifuges at 14,000 revolution per minutes (RPM) for 5 min. Optical density or absorbance of the supernatant solution was measured with UV spectrophotometer at 550 nm. RESULTS: The absorbance of the supernatant solution after dye extraction is decreasing in the order of positive control> GIC > MTA > Biodentine> negative control group. The significant difference was observed between GIC and MTA (p = 0.0001) and GIC and Biodentine (p = 0.0001) with two different burs but statistically non-significant difference was observed between MTA and Biodentine with Carbide bur (p = 0.127) and Diamond bur (p = 0.496) respectively. CONCLUSIONS: Within the limitations of the present study, it can be concluded that Biodentine and MTA showed less microleakage as compared to GIC. There is no significant difference between mean microleakage of MTA and Biodentine. However, the mean OD of the Biodentine was least of all evaluated materials. Preparation of the root-end using round carbide bur as well as round diamond burs showed comparable microleakage for all three filling materials.
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Compuestos de Aluminio/farmacología , Apicectomía/métodos , Compuestos de Calcio/farmacología , Cementos Dentales/química , Filtración Dental/prevención & control , Óxidos/química , Materiales de Obturación del Conducto Radicular/farmacología , Silicatos/farmacología , Ápice del Diente/efectos de los fármacos , Compuestos de Aluminio/química , Compuestos de Calcio/química , Filtración Dental/diagnóstico , Combinación de Medicamentos , Humanos , Pemetrexed , Materiales de Obturación del Conducto Radicular/química , Silicatos/química , Resultado del TratamientoRESUMEN
AIM: The aim of this in vitro study was to evaluate and compare the microleakage of mineral trioxide aggregate (MTA) and Geristore root-end filling materials in different environments. MATERIALS AND METHODS: After removing the anatomical crowns of ninety extracted human maxillary central incisors, their root canals were instrumented and obturated. The apical 3 mm of each root was resected, and a standardized root-end cavity was prepared using an ultrasonic tip. The roots were alienated into three equal subgroups for each material and the root-end filling was performed in different environments namely dry, saliva contaminated, and blood contaminated. Samples were immersed in 0.2% Rhodamine B dye for 48 h. Roots were sectioned longitudinally and examined under a fluorescent microscope to measure the linear dye penetration. The results were statistically analyzed using analysis of variance and Tukey's honestly significant difference post hoc test. RESULTS: The Geristore dry group illustrated the lowest linear leakage, while the MTA saliva-contaminated group illustrated the highest leakage. In dry environment, linear dye penetration of both MTA and Geristore groups did not show any significant difference. However, statistically significant difference was observed between MTA and Geristore groups in blood- and saliva-contaminated environments. CONCLUSION: Geristore showed better results in saliva- and blood-contaminated environments; hence, Geristore may be used as an alternative to MTA for root-end filling.
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INTRODUCTION: The success of endodontic regeneration lies in the appropriate combination of stem cells and bioactive materials. Several novel dental materials are available on the market in this regard. Hence, the current study aimed to evaluate the proliferation, differentiation, and osteogenic potential of human bone marrow-derived mesenchymal stem cells (hBMSCs) onto biomaterials like ProRoot MTA (MTA; Dentsply Tulsa Dental, Tulsa, OK), Biodentine (BD; Septodont, Saint Maur de Fosses, France), and EndoSequence Root Repair Material (ERRM; Brasseler USA, Savannah, GA). METHODS: Dental cements were formulated into discs and assessed for their biocompatibility. hBMSCs were used to study biocompatitibility and the proliferative and osteogenic potential of these dental cements. A live dead assay was performed using confocal microscopy to study the biocompatibility, proliferation, and cell attachment property of the cements. An 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was also performed on days 1, 3, 5, and 7 to study growth kinetics. The osteogenic potential of these cements was studied by inducing hBMSCs over them using osteogenic differentiation medium (assessed by alkaline phosphatase assay). RESULTS: ERRM and MTA have shown the best biocompatibility among the tricalcium silicate materials used with no significant difference between them. Both have shown significantly higher osteogenic bioactivity than BD. All 3 tricalcium silicate cements support good adherence of hBMSCs. CONCLUSIONS: All of the dental cements used in this study are biocompatible with the potential to induce proliferation and osteogenic differentiation of hBMSCs. Therefore, the newly introduced ERRM can be the material of choice in various endodontic applications.
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Materiales Biocompatibles/farmacología , Compuestos de Calcio/farmacología , Cementos Dentales/farmacología , Células Madre Mesenquimatosas/efectos de los fármacos , Osteogénesis/efectos de los fármacos , Silicatos/farmacología , Células Cultivadas , Humanos , Ensayo de MaterialesRESUMEN
OBJECTIVE: The aim of this study was to evaluate the bond strength of three calcium silicate-based root-end filling materials. MATERIALS AND METHODS: The root canals of 30 single-rooted teeth were endodontically treated; their root ends were resected and root-end cavities were prepared using ultrasonic tip. The teeth were randomly divided into three groups according to the material: (1) Micro-Mega mineral trioxide aggregate (MM-MTA), (2) Biodentine, and (3) TotalFill root repair material (RRM). Push-out test was performed using universal testing machine, and failure mode was analyzed by stereomicroscope. The data were statistically analyzed using Kruskal-Wallis and Man-Whitney post hoc tests. All p values < 0.05 were considered significant. RESULTS: TotalFill RRM exhibited significantly higher bond strength (12.69 MPa) than Biodentine (9.34 MPa, p = 0.023) and MM-MTA (7.89 MPa, p = 0.002). The difference between Biodentine and MM-MTA was not significant (p = 0.447). Mixed failures were the most noted in all three groups. MM-MTA had more adhesive failures than Biodentine and TotalFill, and no cohesive failures, but without statistical significance (p = 0.591). CONCLUSION: The bond strength was the highest for TotalFill RRM. CLINICAL RELEVANCE: In order to provide a persistent apical seal, root-end filling materials should resist dislodgement under static conditions, during function and operative procedures. TotalFill RRM exhibited higher bond strength to dentin than MM-MTA and Biodentine.
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Compuestos de Calcio/química , Recubrimiento Dental Adhesivo/métodos , Materiales de Obturación del Conducto Radicular/química , Obturación del Conducto Radicular/métodos , Silicatos/química , Ultrasonido , Compuestos de Aluminio/química , Fracaso de la Restauración Dental , Combinación de Medicamentos , Humanos , Técnicas In Vitro , Incisivo , Ensayo de Materiales , Óxidos/química , Propiedades de SuperficieRESUMEN
INTRODUCTION: Microorganisms, predominantly Enterococcus faecalis are found responsible in the progression of pulpal, periradicular diseases and in endodontic failures. Unsuccessful conventional treatment might necessitate the need for a surgical approach; where in retrograde restorative materials are used to seal the apex. Among the root end filling materials, Mineral Trioxide Aggregate (MTA) is considered biocompatible and is most commonly used in clinical applications but it has limited antibacterial activity. Metallic silver and chlorhexidine have been added into various dental materials to enhance the antibacterial activity. AIM: This study aimed to compare the antibacterial effect of MTA, MTA mixed with silver zeolite and MTA mixed with chlorhexidine against Enterococcus faecalis. MATERIALS AND METHODS: Test materials used in the study were divided into three groups namely Group 1- MTA, Group 2-MTA + Silver Zeolite, Group 3-MTA + Chlorhexidine. Direct contact test was done by placing a standardized suspension of Enterococcus faecalis on the test materials in a 96 well microtiter plate. The bacterial growth was measured spectrophotometrically using ELISA reader at intervals of one, three and seven days. STATISTICAL ANALYSIS: Data was collected by recording the optical density and analyzed using two-way ANOVA and Tukey's multiple post hoc test followed by paired-t test. RESULTS AND CONCLUSION: All test groups showed antibacterial activity against Enterococcus faecalis at day one, three and seven. MTA with silver zeolite showed the maximum antibacterial activity followed by MTA with 2% chlorhexidine. The least antibacterial effect was shown by MTA mixed with sterile water.
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OBJECTIVE: The purpose of this study was to evaluate fracture resistance of teeth with immature apices treated with coronal placement of mineral trioxide aggregate (MTA), bioaggregate (BA), and Biodentine. MATERIALS AND METHODS: Forty-one freshly extracted, single-rooted human premolar teeth were used for the study. At first, the root length was standardized to 9 mm. The crown-down technique was used for the preparation of the root canals using the rotary ProTaper system (Dentsply Maillefer, Ballaigues, Switzerland) of F3 (30). Peeso reamer no. 6 was stepped out from the apex to simulate an incompletely formed root. The prepared roots were randomly assigned to one control (n = 5) and three experimental (n = 12) groups, as described below. Group 1: White MTA (Angelus, Londrina, Brazil) was prepared as per the manufacturer's instructions and compacted into the root canal using MAP system (Dentsply Maillefer, Ballaigues, Switzerland) and condensed by pluggers (Angelus, Londrina, Brazil). Group 2: The canals were filled with DiaRoot-BA (DiaDent Group International, Canada). Group 3: Biodentine (Septodont, Saint Maur des Fosses, France) solution was mixed with the capsule powder and condensed using pluggers. Instron was used to determine the maximum horizontal load to fracture the tooth, placing the tip 3 mm incisal to the cementoenamel junction. Mean values of the fracture strength were compared by ANOVA followed by a post hoc test. P < 0.05 was considered statistically significant. RESULTS: No significant difference was observed among the MTA, BA, and biodentine experimental groups. CONCLUSION: All the three materials tested, may be used as effective strengthening agents for immature teeth.
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OBJECTIVES: The objective of this study was to evaluate the bond strength of three root-end filling materials (MTAA-MTA Angelus, MTAS-experimental MTA Sealer, and ZOE- zinc oxide and eugenol cement) in retrograde preparations performed with different ultrasonic tips (CVD, Trinity, and Satelec). MATERIALS AND METHOD: Ninety 2-mm root sections from single-rooted human teeth were used. The retrograde cavities were prepared by using the ultrasonic tips, coupled to a device for position standardization. The specimens were randomly divided into nine groups: CVD MTAA; CVD MTAS; CVD ZOE; Trinity MTAA; Trinity MTAS; Trinity ZOE; Satelec MTAA; Satelec MTAS; Satelec ZOE. Each resin disc/dentin/root-end filling material was placed in the machine to perform the push-out test. The specimens were examined in a stereomicroscope to evaluate the type of failure. Data were submitted to statistical analysis using ANOVA and Tukey tests (α = 0.05). RESULTS: The highest bond strength was observed for the CVD tip irrespective of the material used (P < 0.05). There was no significant difference for the Trinity TU-18 diamond and S12 Satelec tips (P > 0.05). MTAA and MTAS showed highest bond strength. The most common type of failure was adhesion between the filling material and dentin wall, except for ZOE, where mixed failure was predominant. CONCLUSIONS: The CVD tip favored higher bond strength of the root-end filling materials. MTA Angelus and experimental MTAS presented bond strength to dentin prepared with ultrasonic tips. CLINICAL RELEVANCE: Root-end preparation with the CVD tip positively influences the bond strength of root-end filling materials. MTA Angelus and experimental MTAS present bond strength to be used as root-end filling materials.
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Materiales de Obturación del Conducto Radicular/química , Preparación del Conducto Radicular/instrumentación , Ultrasonido/instrumentación , Bismuto , Recubrimiento Dental Adhesivo , Humanos , Técnicas In Vitro , Ensayo de Materiales , Óxidos , Silicatos , Cemento de Óxido de Zinc-EugenolRESUMEN
CONTEXT: Where nonsurgical endodontic intervention is not possible, or it will not solve the problem, surgical endodontic treatment must be considered. A major cause of surgical endodontic failures is an inadequate apical seal, so the use of the suitable substance as root-end filling material that prevents egress of potential contaminants into periapical tissue is very critical. AIMS: The aim of the present ex-vivo study was to compare and evaluate the three root-end filling materials of mineral trioxide aggregate (MTA) family (white MTA [WMTA], grey MTA [GMTA] and Portland cement [PC]) for their marginal adaptation at the root-end dentinal wall using scanning electron microscopy (SEM). MATERIALS AND METHODS: Sixty human single-rooted teeth were decoronated, instrumented, and obturated with Gutta-percha. After the root-end resection and apical cavity preparation, the teeth were randomly divided into three-experimental groups (each containing 20 teeth) and each group was filled with their respective experimental materials. After longitudinal sectioning of root, SEM examination was done to determine the overall gap between retrograde materials and cavity walls in terms of length and width of the gap (maximum) at the interface. Descriptive statistical analysis was performed to calculate the means with corresponding standard errors, median and ranges along with an analysis of variance and Tukey's test. RESULTS: The least overall gap was observed in GMTA followed by PC and WMTA. While after statistically analyzing the various data obtained from different groups, there was no significant difference among these three groups in terms of marginal adaptation. CONCLUSION: GMTA showed the best overall adaptation to root dentinal wall compared to PC and WMTA. Being biocompatible and cheaper, the PC may be an alternative but not a substitute for MTA.
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BACKGROUND: The aim of this research was to compare the apical sealing ability of different root-end filling materials (SuperEBA(®), ProRoot MTA(®), thermoplasticized gutta-percha + AH-Plus(®), thermoplasticized RealSeal(®)), by means of microbial indicators. MATERIALS AND METHODS: Thus, 50 human single-rooted teeth were employed, which were shaped until size 5 0, retro - prepared with ultrasonic tips and assigned to 4 groups, retro-filled with each material or controls. A platform was employed, which was split in two halves: upper chamber-where the microbial suspension containing the biological indicators was introduced (E. faecalis + S. aureus + P. aeruginosa + B. subtilis + C. albicans); and a lower chamber containing the culture medium brain, heart influsion, where 3 mm of the apical region of teeth were kept immersed. Lectures were made daily for 60 days, using the turbidity of the culture medium as indicative of microbial contamination. Statistical analyses were carried out at 5% level of significance. RESULTS: The results showed microbial leakage at least in some specimens in all of the groups. RealSeal(®) has more microbial leakage, statistically significant, compared to ProRoot(®) MTA and SuperEBA(®). No significant differences were observed when compared ProRoot(®) MTA and SuperEBA(®). The gutta-percha + AH Plus results showed no statistically significant differences when compared with the other groups. CONCLUSIONS: All the tested materials showed microbial leakage. Root-end fillings with Super-EBA or MTA had the lowest bacterial filtration and RealSeal shows highest bacterial filtration.
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Recubrimiento Dental Adhesivo , Obturación Retrógrada/métodos , Materiales de Obturación del Conducto Radicular/química , Compuestos de Aluminio/química , Bacillus subtilis/aislamiento & purificación , Compuestos de Calcio/química , Candida albicans/aislamiento & purificación , Resinas Compuestas/química , Filtración Dental/microbiología , Recubrimientos Dentinarios/química , Combinación de Medicamentos , Enterococcus faecalis/aislamiento & purificación , Resinas Epoxi/química , Gutapercha/química , Humanos , Humedad , Ensayo de Materiales , Nefelometría y Turbidimetría/métodos , Óxidos/química , Pseudomonas aeruginosa/aislamiento & purificación , Distribución Aleatoria , Preparación del Conducto Radicular/métodos , Silicatos/química , Staphylococcus aureus/aislamiento & purificación , Temperatura , Factores de TiempoRESUMEN
This study evaluated the bond strength of root-end filling materials to root-end cavities using a new methodology. Twenty maxillary central incisors were subjected to biomechanical preparation (#80 hand file) and sectioned transversally 2 mm short of the apex and 4 mm coronally to this point. The root cylinders were embedded in acrylic resin and positioned at 45° to the horizontal plane for preparation of root-end cavities with a diamond ultrasonic retrotip. Two groups (n=10) were formed according to the root-end filling material: MTA and Super EBA. A gutta-percha cone (#80) was tug-backed at the limit between the canal and the root-end cavity. The cavity was filled and the gutta-percha cone was removed after complete setting of the sealer. The specimens were placed in an Instron machine with the root-end filling turned downwards. The push-out shaft was inserted in the space previously occupied by the gutta-percha cone and run at a crosshead speed of 1.0 mm/min for pushing out the root-end filling material. Data were analyzed by ANOVA (α=5%). Super EBA (6.03±1.31) presented higher bond strength (MPa) than MTA (1.81±0.45) (p>0.05). There was a predominance of cohesive failures for Super EBA and mixed for MTA. The protocol of specimen preparation is effective and introduces a specific methodology for assessing bond strength of root-end filling materials to dentin. Among the materials, Super EBA presented the highest bond strength.
Este estudo avaliou a resistência de união de materiais retrobturadores a cavidades retrógradas, usando uma nova metodologia. Vinte incisivos centrais superiores foram submetidos ao preparo biomecânico (lima manual #80) e seccionadas transversalmente a 2 mm do ápice e a 4 mm do primeiro corte. Os cilindros de raízes foram incluídos em resina acrílica e posicionado a 45° em relação ao plano horizontal para confecção das retrocavidades com ponta ultrassônica diamantada. Dois grupos (n = 10) foram formados de acordo com os cimentos utilizados: MTA e Super EBA. Um cone de guta-percha (#80) foi travado no limite da retrocavidade com o canal radicular. A retrocavidade foi preenchida e, após o tempo de endurecimento do cimento utilizado, o cone de guta-percha foi removido. Os espécimes foram fixados na máquina universal de ensaios Instron com a retrobturação voltada para baixo. A haste empregada para pressionar o cimento retrobturador no teste de push-out foi inserida no espaço anteriormente ocupado pela guta-percha e acionada com velocidade de cruzeta de 1,0 mm/min, para extrusão do material retroburador. Os dados foram analisados por meio do teste ANOVA (α=5%). O cimento Super EBA (6,03 ± 1,31) apresentou maior resistência de união (MPa) comparado ao cimento MTA (1,81 ± 0,45) (p> 0,05). Houve predomínio de falhas coesivas para o cimento Super EBA e falhas mistas para o MTA. O protocolo de preparação das amostras é eficaz e apresenta uma metodologia específica para avaliação da resistência de união de materiais retrobturadores à dentina. Dentre os materiais testados, o cimento Super EBA apresentou a maior resistência de união.
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Humanos , Ensayo de Materiales , Materiales de Obturación del Conducto Radicular , Técnicas In Vitro , IncisivoRESUMEN
Background and aims. Different materials have been used for root-end filling during surgical endodontic treatment. The aim of this in vitro study was to evaluate the dye penetration in different thicknesses of calcium enriched mixture (CEM) cement as root-end filling material. Materials and methods. Following root canal filling in 70 extracted human single-rooted premolar teeth, the apical 3 mm of their root-ends was resected; the root-end cavities with depths of 1, 2 and 3 mm were prepared by ultrasonic retrotips and filled with CEM cement. After setting of cement, the roots were immersed in 2% Rhodamine B and the dye leakage was measured under stereomicroscope (×16) using Image J software. The data were analyzed by one-way ANOVA and Bonferroni post hoc tests at 5% significance level. Results. The means and standard deviations of dye penetration in the 1, 2, and 3 mm groups were 3395.5±1893.4, 3410.4±1440.5, and 2581.6±1852.9 µm, respectively. The one-way ANOVA analysis indicated significant differences (P < 0.001); however, the Bonferroni post hoc test revealed that only the positive control group differed significantly from the experimental groups (P < 0.001). Conclusion. The findings demonstrated CEM cement to have an adequate root-end sealing ability in 3-mm thickness.
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AIM: The purpose of the study is to evaluate and compare the biological and chemical-physical properties of four different root-end filling materials. MATERIALS AND METHODS: Cytotoxicity towards murine odontoblasts cells (MDPC-23) was evaluated using the Transwell insert methodology by Alamar blue test. Streptococcus salivarius, S. sanguis, and S. mutans strains were selected to evaluate the antimicrobial activity by agar disc diffusion test. Solubility was determined after 24 h and 2 months. pH values were measured after 3 and 24 h. To evaluate radiopacity, all materials were scanned on a GE Healthcare Lunar Prodigy. RESULTS: Excellent percentage of vitality were obtained by mineral trioxide aggregate (MTA)-based materials and Biodentine. MTA-Angelus, ProRoot MTA, and Intermediate Restorative Material (IRM) showed the highest values for the inhibition zones when tested for S. mutans, while Biodentine showed the largest inhibition zone when tested for S. sanguis. All the materials fulfilled the requirements of the International Standard 6876, demonstrating low solubility with a weight loss of less than 3%. No significant reduction in pH value was demonstrated after 24 h. ProRoot MTA and MTA-Angelus showed the highest values of radiographic density. CONCLUSIONS: The differences showed by the root-end filling materials tested do not cover completely the ideal clinical requests.
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INTRODUCTION: The purpose of this study was to compare solubility of a new calcium silicate-based cement, Biodentine with three commonly used root-end filling materials viz. glass-ionomer cement (GIC), intermediate restorative material (IRM), and mineral trioxide aggregate (MTA). MATERIALS AND METHODS: Twenty stainless steel ring molds were filled with cements corresponding to four groups (n = 5). The weight of 20 dried glass bottles was recorded. Samples were transferred to bottles containing 5 ml of distilled water and stored for 24 h. The bottles were dried at 105ÎC and weighed. This procedure was repeated for 3, 10, 30, and 60 days. Data was analyzed with one-way analysis of variance (ANOVA) test (P < 0.05). RESULTS: Biodentine demonstrated significantly higher solubility than MTA for 30- and 60-day immersion periods. Statistical difference was noted between the solubility values of Biodentine samples amongst each of the five time intervals. CONCLUSIONS: Biodentine exhibited higher solubility in comparison with all other cements.
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INTRODUCTION: The aim of this in vitro study was to evaluate the effect of 2% chlorhexidine (CHX) on the push-out bond strength (BS) of calcium-enriched mixture (CEM) cement. METHODS AND MATERIALS: Root-dentin slices from 60 single-rooted human teeth with the lumen diameter of 1.3 mm were used. The samples were randomly divided into 4 groups (n=15), and their lumens were filled with CEM cement mixed with either its specific provided liquid (groups 1 and 3) or 2% CHX (groups 2 and 4). The specimens were incubated at 37(°)C for 3 days (groups 1 and 2) and 21 days (groups 3 and 4). The push-out BS were measured using a universal testing machine. The slices were examined under a light microscope at 40× magnification to determine the nature of bond failure. The data were analyzed using the two-way ANOVA. For subgroup analysis the student t-test was applied. The level of significance was set at 0.05. RESULTS: After three days, there was no significant difference between groups 1 and 2 (P=0.892). In the 21-day specimens the BS in group 3 (CEM) was significantly greater than group 4 (CEM+CHX) (P=0.009). There was no significant difference in BS between 3 and 21-day samples in groups 2 and 4 (CEM+CHX) (P=0.44). However, the mean BS after 21 days was significantly greater compared to 3-day samples in groups 1 and 3 (P=0.015). The bond failure in all groups was predominantly of cohesive type. CONCLUSION: Mixing of CEM with 2% CHX had an adverse effect the bond strength of this cement.
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INTRODUCTION: The aim of this study was to evaluate MTA Plus (Prevest Denpro Limited, Jammu, India, for Avalon Biomed Inc) material's properties, namely calcium release, the pH change, solubility, water sorption, porosity, surface morphology, and apatite-forming ability after immersion in simulated body fluid. METHODS: Two tricalcium silicate powders (MTA Plus and ProRoot MTA; Dentsply Tulsa Specialties, Tulsa, OK) and Dycal (Dentsply Caulk, Milford, DE) were tested. After incubation at 37°C and 99% relative humidity, calcium and hydroxyl ion release were tested up to 28 days in deionized water at 37°C. Water absorption, interconnected pores, apparent porosity, and solubility were measured after 24 hours of immersion in deionized water at 37°C. The morphologic and elemental analysis of the materials' surfaces were examined using an environmental scanning electron microscope/energy dispersive x-ray analysis after storage at 37°C for 1-28 days in simulated body fluid using the ISO 23317 method. RESULTS: All 3 materials created an alkaline pH within 3 hours, which continued for 28 days. MTA Plus had a higher ion release than ProRoot MTA and Dycal; the use of the MTA Plus gel enhanced the initial calcium release and the increase of the pH. Both MTA materials were more porous, water soluble, and water sorptive than Dycal and more bioactive. After aging in simulated body fluid, MTA Plus material caused precipitation of an apparent calcium phosphate layer. CONCLUSIONS: MTA Plus showed improved reactivity and prolonged capability to release calcium and increase the local pH to alkaline values in comparison with ProRoot MTA. These pronounced ion-releasing properties are interlinked with its noticeable porosity, water sorption, and solubility and with the formation of calcium phosphorus minerals. The finer calcium silicate powder may explain the higher ion release, water sorption, porosity, and solubility of MTA Plus compared with ProRoot MTA. For clinicians, MTA Plus represents a lower-cost bioactive tricalcium silicate material with interesting chemical-physical properties that could be a convenient alternative to the conventional calcium silicate mineral trioxide aggregate-like cements.