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Aim: To evaluate, using a novel micro-CT approach, the solubility and dimensional changes of an MTA-based sealer inside the root canal system after a solubility challenge. The MTA-based material (MTA Fillapex) was compared to a gold standard epoxy-based endodontic sealer (AH Plus)., Methodology: Ten human mandibular premolars with a single canal were divided randomly into two groups (n = 5) according to the sealer used. The canals were instrumented using the Reciproc System (VDW) with a R40 file and filled with R40 gutta-percha cones and one of the sealers. The filled canals were immediately scanned in a micro-CT, and after that, the teeth were immersed in 20 mL phosphate-buffered saline (PBS) at 37 °C for 7 days, when they were removed and rescanned. Final image stacks were registered against the initial stacks and the numerical difference between the initial and final volume of the filling material was obtained. Calculations were performed to identify dimensional changes of the filling material. All image stacks were 3D rendered to disclose areas of dislocation of the filling material inside or outside the root canal. The Shapiro-Wilk's test revealed that data were normally distributed; thus, the Student's t-test was used to detect statistically significant changes, assuming a 5% α-error., Results: No significant changes were seen for the percentage volume of material lost after the solubility challenge for both AH Plus and MTA Fillapex groups (1.44% and 1.16%, respectively). A significant difference was, however, found for the volume of filling material which revealed dimensional changes after the solubility test (6.68% for MTA Fillapex and 1.09% for AH Plus). In fact, observation of 3D models disclosed that MTA Fillapex was associated with material extrusion through the foramen in all but one sample. In AH Plus filled samples, no material extrusion was detected., Conclusions: Although the solubility of both sealers was similar using this novel micro-CT approach, MTA Fillapex was associated with significant dimensional changes related to material extrusion through the apex after PBS storage compared to AH Plus., (© 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.)

Aim: To evaluate and compare the push-out bond strength of MTA Fillapex (Angelus, Londrina, Brazil) and iRoot SP (Innovative BioCeramix Inc., Vancouver, Canada) to the dentine walls of root canals. AH Plus (Dentsply DeTrey, Konstaz, Germany) and MTA (Angelus, Londrina, Brazil) were used as reference materials., Methodology: Sixty extracted human single-rooted teeth were selected. After standardized canal preparation and irrigation, the canals were dried with paper points and filled with one of four sealers: AH Plus, iRoot SP, MTA and MTA Fillapex. Roots were sectioned, and push-out tests were performed. The values of bond strength were analysed using the Kruskal-Wallis test. Mann-Whitney with Bonferroni correction was used to isolate the differences. The alpha-type error was set at 0.05 for the analyses., Results: All specimens had measurable adhesion to root dentine and no premature failure occurred. There were significant differences amongst materials (P = 0.000). MTA-filled specimens had higher push-out bond strength values (P = 0.000). AH Plus had significantly higher bond strength than both Fillapex and iRoot SP (P = 0.000). Both Fillapex and iRoot SP had the lowest push-out bond strength amongst all experimental groups (P = 0.000). No difference occurred between the two calcium silicate-based root canal sealers (P = 0.265)., Conclusion: The adhesion to root dentine associated with newer calcium silicate-based sealers was compromised even when well-monitored laboratory conditions were used., (© 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.)

This study was designed to investigate the resistance to dislodgment provided by MTA HP, a new high-plasticity calcium silicate-based cement. Biodentine and White MTA Angelus were used as reference materials for comparison. Three discs 1 ± 0.1 mm thick were obtained from the middle third of the roots of 5 maxillary canines. Three 0.8-mm-wide holes were drilled on the axial surface of each root disc. Standardized irrigation was performed. Then the holes were dried with paper points and filled with one of the three tested cements. The filled dental slices were immersed in a phosphate-buffered saline (PBS) solution (pH 7.2) for 7 days before the push-out assessment. The Kruskal-Wallis test was applied to assess the effect of each endodontic cement on the push-out bond strength. Mann-Whitney with Bonferroni correction was used to isolate the differences. The alpha-type error was set at 0.05. All specimens had measurable push-out values and no premature failure occurred. There were significant differences among the materials (p <0.05). The Biodentine specimens had the highest push-out bond strength values (p < 0.05). MTA HP had significantly higher bond strength than White MTA (p < 0.05). MTA HP showed better push-out bond strength than its predecessor, White MTA; however, Biodentine had higher dislodgment resistance than both MTA formulations.

Unlabelled: A calcium aluminate-based endodontic material, EndoBinder, has been developed in order to reduce MTA negative characteristics, preserving its biological properties and clinical applications., Objectives: The aim of this study was to evaluate the cytotoxicity, antimicrobial activity, pH, solubility and water sorption of EndoBinder and to compare them with those of white MTA (WMTA)., Material and Methods: Cytotoxicity was assessed through a multiparametric analysis employing 3T3 cells. Antimicrobial activity against Enterococcus faecalis (ATCC 29212), Staphylococcus aureus. (ATCC 25923) and Candida albicans (ATCC 10556) was determined by the agar diffusion method. pH was measured at periods of 3, 24, 72 and 168 hours. Solubility and water sorption evaluation were performed following ISO requirements. Data were statistically analyzed by ANOVA and Tukey`s test with a significance level of 5%., Results: EndoBinder and WMTA were non-cytotoxic in all tested periods and with the different cell viability parameters. There was no statistical differences between both materials (P>.05). All tested materials were inhibitory by direct contact against all microbial strains tested. EndoBinder and WMTA presented alkaline pH in all tested times with higher values of pH for WMTA (P<.05). Both materials showed values complying with the solubility minimum requirements. However, EndoBinder showed lower solubility than WMTA (P<.05). No statistical differences were observed regarding water sorption (P>.05)., Conclusion: Under these experimental conditions, we concluded that the calcium aluminate-based endodontic material EndoBinder demonstrated suitable biological and physicochemical properties, so it can be suggested as a material of choice in root resorption, perforations and root-end filling.

Introduction: The aim of this study was to evaluate and compare several physicochemical properties including working and setting times, flow, solubility, and water absorption of a recent calcium silicate-based sealer (MTA Fillapex; Angelus, Londrina, Brazil) and an epoxy resin-based sealer (AH Plus; Dentsply, Konstanz, Germany)., Methods: The materials were handled following the manufacturer's instructions. The working time and flow were tested according to ISO 6876:2001 and the setting time according to American Society for Testing and Materials C266. For solubility and water absorption tests, the materials were placed into polyvinyl chloride molds (8 × 1.6 mm). The samples (n = 10 for each material and test) were placed in a cylindrical polystyrene-sealed container with 20 mL deionized water at 37°C. At 1, 7, 14, and 28 days, the samples were removed from the solutions and blotted dry for solubility and water absorption tests. The data were analyzed using 1-way analysis of variance with the Tukey test (P < .05)., Results: MTA Fillapex showed the lowest values of flow, working and setting times, solubility, and water absorption (P < .05). The solubility and water absorption increased significantly over time for both materials in a 1- to 28-day period (P < .05)., Conclusions: MTA Fillapex showed suitable physical properties to be used as an endodontic sealer., (Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: The aim of the study was to evaluate the cytotoxicity, radiopacity, pH, and flow of a calcium silicate-based and an epoxy resin-based endodontic sealer, MTA Fillapex (Angelus, Londrina, PR, Brazil) and AH Plus (Dentsply, Konstanz, Germany), respectively., Methods: Cytotoxicity, radiopacity, and flow evaluation were performed following ISO requirements. The pH level was measured at periods of 3, 24, 72, and 168 hours. Cytotoxicity was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay to check the Balb/c 3T3 cells viability at 1- to 4-week periods. Data were statistically analyzed by analysis of variance and the Tukey test with a significance level of 5%., Results: In all tested periods, MTA Fillapex was more cytotoxic than AH Plus (P < .05). Although AH Plus presented higher radiopacity than MTA Fillapex (P < .05), both sealers showed minimum required values. MTA Fillapex presented alkaline pH in all experimental times, whereas AH Plus cement showed a slightly neutral pH and a flow significantly lower than that of MTA Fillapex (P < .05)., Conclusions: Although MTA Fillapex was more cytotoxic than AH Plus, it showed suitable physicochemical properties for an endodontic sealer., (Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Furcal perforations are significant iatrogenic complications of endodontic treatment and could lead to endodontic failure. Mineral trioxide aggregate (MTA) has been regarded as an ideal material for perforation repair, retrograde filling, pulp capping, and apexification. This case report describes a furcal perforation in a maxillary first molar, which was repaired using MTA. The tooth was endodontically treated and coronally restored with resin composite. After 2 years, the absence of periradicular radiolucent lesions, pain, and swelling along with functional tooth stability indicated a successful outcome of sealing the perforation using MTA.