Search

Hydraulic calcium silicate-based (HCSB) or “bioceramic” sealers are widely used for root canal obturation and rapidly gaining popularity among general practitioners and endodontists. The premixed or fifth-type HCSB materials can be used with all root canal obturation techniques, such as cold lateral and warm vertical compaction or a single-cone technique. Meanwhile, the fourth-type HCSB sealers are sensitive to heat and desiccation, therefore suitable for cold root canal obturation techniques. Although all obturation techniques are equally effective and not superior to each other, the single-cone obturation technique is easier to apply, and is more time-consuming and clinically appealing in modern endodontics. This article will introduce and discuss the most popular HCSB sealers and root canal obturation techniques used in conjunction with these materials.

The aim of this systematic review is to investigate the teeth discoloration potential of Biodentine. An electronic search in six databases (PubMed, Cochrane Library, LILACS, SCIELO, Web of Science, and Scopus) was conducted by three independent reviewers to identify eligible articles. The following search terms were used: ((discolo*, staining potential, color, colour, or spectrophotomet*), (teeth or tooth), and (Biodentine)). Methodology following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines was adopted for this investigation. At the end of the selection process, 30 articles were identified as eligible, of which 14 in vitro studies were included in this systematic review. Nine of the included studies evaluated the discoloration potential of Biodentine in the presence of blood. Within the limitations of this review, teeth discoloration using Biodentine is highly expected when material is placed in direct contact with blood during dental procedures. In the absence of blood, Biodentine causes less teeth color changes than MTA-based materials, but it is still unclear what clinically relevant results could be expected regarding the discoloration frequency and intensity induced by Biodentine.

The present study evaluated the effect of ultrasonic agitation on the porosity distribution of BioRoot RCS/single gutta-percha cone (BR/SC) and MTA Flow (MF) root canals fillings used as apical plugs in moderately curved and apically perforated roots. Eighty mesial root canals of mandibular first molars were enlarged up to ProTaper NEXT X5 rotary instrument 2 mm beyond the apical foramen, simulating apical perforations. Specimens were randomly divided into four experimental groups (20 canals per group) according to the material and technique used for root canal obturation: BR/SC, BR/SC with ultrasonic agitation (BR/SC-UA), MF and MF with ultrasonic agitation (MF-UA). The ultrasonic tip was passively inserted into the root canal after the injection of flowable cement and activated for 10 s. The specimens were scanned before and after obturation with a high-resolution micro-computed tomography scanner, and the porosity of the apical plugs was assessed. The differences between groups were analyzed using the Kruskal-Wallis and Mann-Whitney tests, with the significance level set at 5%. None of the obturation materials and techniques used in this study was able to provide a pore-free root canal filling in the apical 5 mm. Considerably higher percentages of open and closed pores were observed in the MF and MF-UA groups, with the highest porosity being in the MF-UA group (p &lt, 0.05). No significant differences were observed between the BR/SC and BR/SC-UA groups, where the quantity of open and closed pores remained similar (p &gt, 0.05).

The objective of this study was to assess the porosity distribution of BioRoot RCS/single gutta-percha point root-canal fillings performed by a general dental practitioner and endodontist. Fourteen plastic models of maxillary premolars with two roots were selected and shaped with HyFlex EDM instruments to a size 40/0.04 taper and randomly divided into two experimental groups. A total of 14 canals in each group were obturated by two different operators with one HyFlex EDM size 40 gutta-percha point and BioRoot RCS sealer. The specimens were scanned with a high-resolution micro-computed tomography scanner, and the porosity of the fillings at the coronal, middle, and apical thirds of the root canals was qualified and quantified. The differences between groups and root-canal thirds were compared using Mann–Whitney, Friedman, and Wilcoxon tests with the significance level set at p &lt, 0.05. The highest number of pores was observed in the apical third of root-canal fillings in both groups, however, the porosity distribution between the two groups was not significantly different in the apical and middle thirds (p &gt, 0.05). Statistically significant differences were determined only in the coronal third (p &lt, 0.05). The predominance of open pores was detected in all root-canal thirds and groups, with no significant differences in the number of open pores between the coronal and middle thirds (p &gt, 0.05).

The present study evaluated the obturation quality of root canals filled with BioRoot RCS sealer and single gutta-percha point by undergraduate student (US), postgraduate student (PS) and endodontist (ED). Twenty-one plastic models of upper premolars were enlarged with HyFlex EDM instruments to a size 40/0.04 taper and randomly divided into three groups (7 teeth/14 canals per group): US, PS and ED. After the obturation of root canals with BioRoot RCS and one HyFlex EDM size 40 gutta-percha point, plastic models were scanned using micro-computed tomography scanner (µCT) SkyScan 1272 at isotropic resolution of 10 µm. The porosity distribution was evaluated separately for the apical, middle and coronal thirds. The Kruskal–Wallis, Mann–Whitney, Friedman and Wilcoxon tests with the significance level set at 5% were used for data analysis. The µCT evaluation revealed open pores being the dominant type of porosity in all experimental groups and root canal thirds, with the highest percentage of pores in the apical third of root canal fillings. The quality and homogeneity of single cone root canals fillings remained similar between the groups in the apical and middle thirds (p &gt, 0.05). Significant differences were observed only in the coronal third (p &lt, 0.05).

Pulpectomy in deciduous teeth involves endodontic access opening, root canal debridement and obturation with an appropriate filling material. EndoREZ (ER) is the urethane dimethacrylate-based filler, which can be used for root canal obturation in permanent and primary teeth. This observation aimed to evaluate the behavior of the ER as a filler in root canals of two primary molars after the physiological resorption process using the scanning electron microscopy (SEM) and micro-computed tomography (µCT) in second lower molars after their natural exfoliation. The SEM analysis revealed a non-uniform, porous and lacunary structure of ER, visually similar to the resorbed surface of the dentine. The µCT observations demonstrated the differences in the resorption level of the root and material surfaces. The preliminary observations suggest that ER is resorbed faster than root tissues and can therefore be a suitable material for the root canal filling in primary teeth. However, more investigations are needed to support these preliminary findings.

The newer types of hydraulic calcium silicate–based materials (Types 4 and 5) are rapidly gaining popularity among clinicians. These materials are modified by additives which enhance their performance and also presented in different consistencies thus easier to use. Due to their exceptional biological, physicochemical properties, superior handling characteristics, and simplified clinical application, these materials have come into widespread use for the management of endodontic complications. Management of immature apices, repair of root perforations, root resorption defects, filling the retrocavities in endodontic surgery, and other treatment procedures can be performed using these materials with the similar success rates as mineral trioxide aggregate (MTA). This chapter will introduce and discuss the most popular hydraulic calcium silicate–based repair materials and techniques, used for management of endodontic complications.

The fourth and fifth types of hydraulic calcium silicate-based sealers are rapidly gaining popularity among clinicians due to their exceptional biological, physicochemical properties, and simplified clinical application. These materials can be used with all root canal obturation techniques, such as cold lateral or warm vertical compaction techniques, and especially a single-cone technique. Although all obturation techniques are equally effective and not superior to each other, the single-cone obturation technique is easier to apply, is more time-consuming, and clinically appealing in modern endodontics. This chapter will introduce and discuss the most popular hydraulic calcium silicate–based sealers and root canal obturation techniques used in conjunction with these materials.

Objective: The aim of this study was to compare the impact of treatment procedures on roots previously treated with resorcinol–formaldehyde resin and analyze the effectiveness of dye and magnification for the detection of dentin cracks. Materials and methods: Distal roots of 80 permanent first mandibular molars with a single canal were sectioned at 3 mm and 9 mm from the anatomical apex. Two groups were formed according to the method used for root canal penetration: group 1 (K-file and Pro Taper instruments) and group 2 (Ultrasound with Pro Ultra and Pro Taper files). Before and after the completion of procedures, photographs of the roots were taken for examination for cracks or/and infraction lines with two levels of magnification and with or without a dye. Results: In groups 1 and 2, either with dye or without it, there were statistically significant differences (P &lt, 0.001) with more fractures observed in the coronal than in the apical part of specimens. Statistically significant proportional differences regarding the location of fractures were observed at both magnifications. When the dye was used, there were no statistically significant differences between the two magnifications in the detection of cracks. In the specimens where the dye was not used, differences between the groups were statistically significant at both magnifications with more complete and intra-dental fractures observed in group 2. Conclusions: Retreatment methods had a damaging effect on the root dentin of teeth previously treated with resorcinol–formaldehyde resin. At magnification ×16, the efficacy of using the dye for the detection of cracks was higher than detection without the dye.