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Background: Using endodontic sealers with long-term antimicrobial properties can increase the success of endodontic treatment. This study aimed to assess the antimicrobial activity over time of two calcium silicate (CS)-based sealers, AH Plus Bioceramic and BioRoot RCS, and to compare them with an epoxy resin-based sealer, AH Plus Jet, against mature polymicrobial biofilms grown on human radicular dentin. Methods: The antimicrobial activity of the sealers was tested using a direct contact test after 1 and 6 weeks of contact with the biofilms. Cell viability was determined by the adenosine triphosphate (ATP) method and flow cytometry (FC). The results of the ATP test were analyzed using an ANOVA with Welch's correction, followed by the Games–Howell test. The number of cells with damaged membranes obtained by FC in each period was compared by means of an ANOVA and Duncan's test. For the comparison between times, a Student's t-test was used. Results: Globally, after a week of contact, the epoxy resin-based sealer obtained the best results. However, at 6 weeks, the two CSs showed the highest antimicrobial efficacy, with a significant increase in this activity over time. Conclusions: Calcium silicate-based sealers exert long-term antimicrobial activity against endodontic biofilms. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to compare the efficacy of XP-endo finisher R file and PIPS technique using Er: YAG laser on removal of gutta-percha in root canals obturated with two different obturation techniques. Methods: The root canals of sixty single-rooted teeth were prepared with ProTaper Next Rotary instruments up to X3 (Dentsply, Ballaigues, Switzerland). Half of the root canals were obturated with cold lateral condensation technique and the other half with System B technique (Kerr Corporation, CA, USA) and BioRoot RCS sealer (Setodent, Louisville, USA) was used in all groups as a root canal sealer. After one week, all root canals were retreated using Protaper Universal retreatment instruments (Dentsply, Ballaigues, Switzerland) and enlarged to ProTaper Next X5 File at the working length. Both groups were divided into 3 subgroups according to the additional cleaning methods: control group without an additional cleaning method, XP-endo Finisher R or PIPS technique using Er: YAG laser. Finally, all teeth were split longitudinally and images were taken using an operation microscope (Carl Zeiss, Heidelberg, Germany). The images were analyzed by Image J program. Two-way ANOVA and Tukey tests were used for statistical analysis. Results: There was a statistically significant difference between the canal filling techniques applied in the evaluation of remnants (p=0.010). There was no significant difference between additional cleaning methods (p=0.196). Conclusion: Within the limitations of this study, cleanliness is more difficult in root canals obturated with System B technique. Use of additional cleaning method was not effective in removal of root canal filling materials.

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Background: Using endodontic sealers with long-term antimicrobial properties can increase the success of endodontic treatment. This study aimed to assess the antimicrobial activity over time of two calcium silicate (CS)-based sealers, AH Plus Bioceramic and BioRoot RCS, and to compare them with an epoxy resin-based sealer, AH Plus Jet, against mature polymicrobial biofilms grown on human radicular dentin. Methods: The antimicrobial activity of the sealers was tested using a direct contact test after 1 and 6 weeks of contact with the biofilms. Cell viability was determined by the adenosine triphosphate (ATP) method and flow cytometry (FC). The results of the ATP test were analyzed using an ANOVA with Welch’s correction, followed by the Games–Howell test. The number of cells with damaged membranes obtained by FC in each period was compared by means of an ANOVA and Duncan’s test. For the comparison between times, a Student’s t-test was used. Results: Globally, after a week of contact, the epoxy resin-based sealer obtained the best results. However, at 6 weeks, the two CSs showed the highest antimicrobial efficacy, with a significant increase in this activity over time. Conclusions: Calcium silicate-based sealers exert long-term antimicrobial activity against endodontic biofilms.

The aim of this study was to evaluate the aging effect of thermomechanical cyclic load on fracture resistance of lower premolars obturated with AH Plus and BioRoot RCS root canal sealers. Forty-eight single-rooted premolars teeth were instrumented with REVO-S files up to SU/0.06 taper. The teeth were randomly assigned into 2 main groups (n = 24) according to the selected two root canal sealers (AH Plus or BioRoot RCS). All teeth were obturated using matching gutta-percha. Each main group were further divided into 3 subgroups (A, B and C) (n = 8). Group A acted as the negative control group (non-Thermomechanical aging). Whereas Group B and C were subjected first to thermal variations in a thermal cycling machine (7500 and 15,000 thermal cycles), then two different dynamic loading periods namely 3 × 105 and 6 × 105 in a masticatory simulator with a nominal load of 5 kg at 1.2 Hz which simulate approximately 1 ½ and 3 years of clinical function respectively. The roots were decoronated and fracture resistance were measured using a universal testing machine. After thermal-mechanical aging, BioRoot RCS showed significantly higher fracture resistance (p < 0.05) than AH Plus. As the thermal-mechanical cycles increased both AH Plus and BioRoot RCS exhibited a significant decrease in fracture resistance (p < 0.05). It could be concluded that thermomechanical aging had a significant impact on the outcome of the fracture resistance of AH Plus and BioRoot RCS. [ABSTRACT FROM AUTHOR]

Introduction: Root canal fillings using Gutta-percha and root canal sealers are considered the gold standard in endodontics. Bondable root canal sealers help in strengthening the root by penetrating into the dentin. Aim: The aim was to compare and evaluate the fracture resistance of root dentin following the application of AH Plus sealer, MTA Fillapex sealer, and BioRoot RCS sealer. Materials and Methods: Decoronation was performed on 70 extracted single-rooted premolars at the cementoenamel junction. The samples were divided into three experimental and two control groups. Fourteen samples served as the negative control (Group 4), which were left unprepared. The remaining 56 samples were prepared with ProTaper rotary files up to F3. The roots were obturated using cold lateral compaction using Gutta-percha and AH Plus sealer (Group 1), MTA Fillapex (Group 2), and BioRoot RCS (Group 3). Group 5 served as the positive control group. A universal testing machine was used to compress the samples until fracture occurred. One-way analysis of variance with post hoc Tukey's test was used to analyze the data. Results and Discussion: The highest resistance to fracture was shown by Group 4 (negative control), followed by Group 1 (AH Plus), Group 3 (BioRoot RCS), Group 2 (MTA Fillapex), and the least by Group 5 (positive control). There was a statistically significant difference between all the groups (P = 0.00) except between AH Plus and BioRoot RCS (P > 0.05). Conclusion: Samples in all the groups fractured when vertical force was applied. The maximum resistance to fracture was shown by the roots which were neither instrumented nor obturated. AH plus sealer showed the highest resistance to fracture among the three experimental groups, followed by BioRoot RCS and MTA Fillapex.

Aims: The aim is to evaluate the retreatability of BioRoot RCS (BCS)/Gutta-percha (GP) as compared to AH Plus/GP with and without a solvent using cone-beam computed tomography (CBCT). Materials and Methods: Mesio-buccal canals in 48 first mandibular molars were instrumented using iRace rotary files up to size 25.4% and obturated with GP using one of the following sealers, BCS and AH Plus. Post obturation, the teeth were scanned using a CBCT. All samples were divided into four groups (n = 12). Group 1: GP/BCS was removed using D-Race retreatment files and xylene as a solvent; Group 2: GP/BCS was removed using D-Race retreatment files without xylene; Group 3: GP/AH Plus was removed using D-Race retreatment files with xylene; Group 4: GP/AH Plus was removed using D-Race retreatment files without xylene. Time taken to reach the working length (WL) was recorded. Samples were again scanned using CBCT and the remaining filling material was calculated in the coronal, middle, and apical thirds. Data were tabulated and analyzed via Kruskal–Wallis and Mann–Whitney Post hoc test (P < 0.05). Results: Group 3 exhibited significantly less time to reach WL as compared to Group 1. There was no significant difference between Group 2 and Group 4. In all groups, the apical third had the most remaining filling material (Group 1 – 13.75 ± 4.83, Group 2 – 18.33 ± 3.26, Group 3 – 10.42 ± 3.34, Group 4 – 15.42 ± 3.34). WL and patency were re-established in all the samples. Conclusions: Irrespective of the retreatment technique employed complete removal of both the sealers could not be achieved. However, retreatability of AH Plus with xylene was superior to that of BioRoot RCS.

Aim: To find out the effects of 2% chlorhexidine (CHX) gel intracanal medicament on the dislodgement resistance of AH Plus, BioRoot RCS, and GuttaFlow 2 Sealer to dentin and on sealer‑dentin interface. Materials and Methods: Sixty single‑rooted maxillary canine were taken and divided into two groups based on the treatment: Group 1 – control group (no medicament) (n = 30) and Group 2 – (GLUCO‑CHeX 2% Gel) (n = 30). Further, the groups were divided according to the sealer used, namely (A) AH Plus sealer, (B) BioRoot RCS Sealer, and (c) Gutta Flow 2 sealer. Teeth were prepared using rotary instrumentation of file size 35 with a taper of 0.06 and obturation was done. 1 mm thick sections were obtained from the roots. All the sections were checked for push out bond strength using Universal testing machine and mode of failure using stereomicroscope. Some samples were evaluated for sealer‑dentin interface using field emission scanning electron microscope. Results: AH Plus showed higher bond strength compared to BioRoot RCS and GuttaFlow 2. There was no significant difference in the push out bond strength with or without the prior use of 2% CHX medicament (P > 0.05) and also CHX did not affect the mode of failure. However, sealer‑dentin interface gap was increased with application of medicament. Conclusion: Dislodgement resistance of AH Plus sealer is significantly higher than BioRoot RCS and GuttaFlow 2 sealer. The application of 2% CHX intracanal medicament before root canal obturation did not significantly affect the dislodgement resistance of the three tested sealers. 2% CHX medicament did not affect the failure mode of the sealers. Sealer‑dentin interface is affected by the use of 2% CHX gel medicament. [ABSTRACT FROM AUTHOR]

BACKGROUND-An apical seal is one which forms a barrier between the root canal and periapex. A three-dimesional seal is created by use of Gutta Percha and an endodontic sealer, which will fill the discrepancies between the core material and dentinal walls. Since years Gutta Percha has played a versatile role in root canal obturation; but newer materials have been introduced to overcome the hydrophobic nature of it. One such material is C-Point, a premade obturation point, which absorbs residual moisture (hydrophilic nature) from the canals and expands laterally to conform to canal complexities. MATERIALS AND METHOD-Fifteen freshly extracted mandibular incisors were prepared with Protaper Universal rotary files, and obturated by dividing into three groups of 5 teeth each. Group I-Gutta-percha & AH-Plus, Group II, Gutta-percha & Nanoseal S, and Group III C-point & BioRoot RCS. After coating the teeth with nail polish except the apical 2 mm, they were suspended in methylene blue dye for 12 hour. They were then sectioned longitudinally and observed under stereomicroscope for the linear dye penetration. All the groups were compared by using ONE WAY ANOVA. RESULTS- One way ANOVA showed Group I with minimum microleakage (Mean ± SD) of 3.29±1.32 µm, followed by Group II 4.25±1.83 µm and Group III with maximum micro-leakage 5.53±1.72 µm. CONCLUSION- Gutta percha when used with AH-Plus showed better sealing ability as compared to Gutta Percha and Nanoseal S. The newer material, C-Point with BioRoot RCS showed the least sealing ability. [ABSTRACT FROM AUTHOR]

Aim & Objective: The objective of this in vitro research was to assess how final irrigation techniques affected the apical micro leakage of a bioceramic sealer. Materials and Methods: To standardise the canal length, sixty single-rooted mandibular premolar teeth that had been removed were obtained and decoronated. The working length of the root canals was established after accessing them. NiTi rotary files were used to prepare the root canals. Based on the final watering strategy, samples were randomly split into three groups, totaling 20 N. Group1. 5 ml of 17% EDTA for 1min followed by 5ml of 5%NaOCl, 5ml Distilled water. Group2. 5ml of Q MIX 2 in 1, 5ml Distilled water. Group3. 5ml of 2% CHLORHEXIDINE, 5ml Distilled water. Using a single-cone approach and a novel bioceramic sealant, the canals were obturated. To enable the sealer to fully set, all roots were put in 100% humidity and incubated at 37 oC for 24 hours. After the root surfaces had dried, two coats of nail polish had been applied, with the exception of the 2mm at the tip, which had been submerged in 1% methelyne blue for 72 hours. After that, the samples were longitudinally sectioned, and dye penetration was examined using a stereomicroscope (10xmagnification). Using the Image Pro Express 6 software, the maximum apical dye penetration leakage was determined. One-way ANOVA and Tukey's HSD post hoc analysis were used to statistically analyse the data. Results: Of all the experimental groups, Group 1 had the least percentage of apical leakage. Between each group, there were significant variations in the degree of apical micro leakage (P 0.001). Conclusion: Within the constraints of this investigation, it was shown that when Bioroot RCS was used as the sealer, final irrigation with 17% EDTA followed by 5% sodium hypochlorite demonstrated the least degree of apical leakage. [ABSTRACT FROM AUTHOR]

Introduction: Root canal fillings using Gutta-percha and root canal sealers are considered the gold standard in endodontics. Bondable root canal sealers help in strengthening the root by penetrating into the dentin. Aim: The aim was to compare and evaluate the fracture resistance of root dentin following the application of AH Plus sealer, MTA Fillapex sealer, and BioRoot RCS sealer. Materials and Methods: Decoronation was performed on 70 extracted single-rooted premolars at the cementoenamel junction. The samples were divided into three experimental and two control groups. Fourteen samples served as the negative control (Group 4), which were left unprepared. The remaining 56 samples were prepared with Pro Taper rotary files up to F3. The roots were obturated using cold lateral compaction using Gutta-percha and AH Plus sealer (Group 1), MTA Fillapex (Group 2), and BioRoot RCS (Group 3). Group 5 served as the positive control group. A universal testing machine was used to compress the samples until fracture occurred. One-way analysis of variance with post hoc Tu key's test was used to analyze the data. Results and Discussion: The highest resistance to fracture was shown by Group 4 (negative control), followed by Group 1 (AH Plus), Group 3 (BioRoot RCS), Group 2 (MTA Fillapex), and the least by Group 5 (positive control). There was a statistically significant difference between all the groups (P = 0.00) except between AH Plus and BioRoot RCS (P > 0.05). Conclusion: Samples in all the groups fractured when vertical force was applied. The maximum resistance to fracture was shown by the roots which were neither instrumented nor obturated. AH plus sealer showed the highest resistance to fracture among the three experimental groups, followed by BioRoot RCS and MTA Fillapex. [ABSTRACT FROM AUTHOR]

Aim of the Study: The objective of this in-vitro study was to assess the screening capabilities of three endodontic sealers, namely the BioRoot RCS, the MTA Fillapex, and Sealapex (a calcium hydroxide-based sealer), and the gutta-percha cone by using a scanning electron microscopy to the dentine walls. The results from the research are presented here. Results: ZOE exhibited more gaps in the sealing materials evaluated with the least dental sealing performance, followed by the cervical third by the MTA Fillapex, the Sealapex, and the BioRoot RCS. The ZOE, followed by Sealapex, MTA Fillapex, and BioRoot RCS, exhibited inadequate dental wall sealing capacity in the middle of the third. The third apical ZOE exhibited more deficiencies in the formation of dental walls, followed by Sealapex, MTA Fillapex, and BioRoot RCS. Conclusion: Under the constraints of the investigation, it can be stated that for the bioceramic sealer, a minimal gap was seen, with RCS of BioRoot superior to Fillapex of MTA. In the middle third, Sealapex was better adapted to the calcium hydroxide-based sealant than the MTA Fillapex sealer. MTA Filllapex had lower gap development than Sealapex in cervical or apical thirds. [ABSTRACT FROM AUTHOR]

Aims: The aim is to evaluate the retreatability of BioRoot RCS (BCS)/Gutta-percha (GP) as compared to AH Plus/GP with and without a solvent using cone-beam computed tomography (CBCT). Materials and Methods: Mesio-buccal canals in 48 first mandibular molars were instrumented using iRace rotary files up to size 25.4% and obturated with GP using one of the following sealers, BCS and AH Plus. Post obturation, the teeth were scanned using a CBCT. All samples were divided into four groups (n = 12). Group 1: GP/BCS was removed using D-Race retreatment files and xylene as a solvent; Group 2: GP/BCS was removed using D-Race retreatment files without xylene; Group 3: GP/AH Plus was removed using D-Race retreatment files with xylene; Group 4: GP/AH Plus was removed using D-Race retreatment files without xylene. Time taken to reach the working length (WL) was recorded. Samples were again scanned using CBCT and the remaining filling material was calculated in the coronal, middle, and apical thirds. Data were tabulated and analyzed via Kruskal–Wallis and Mann–Whitney Post hoc test (P < 0.05). Results: Group 3 exhibited significantly less time to reach WL as compared to Group 1. There was no significant difference between Group 2 and Group 4. In all groups, the apical third had the most remaining filling material (Group 1 – 13.75 ± 4.83, Group 2 – 18.33 ± 3.26, Group 3 – 10.42 ± 3.34, Group 4 – 15.42 ± 3.34). WL and patency were re-established in all the samples. Conclusions: Irrespective of the retreatment technique employed complete removal of both the sealers could not be achieved. However, retreatability of AH Plus with xylene was superior to that of BioRoot RCS. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the aging effect of thermomechanical cyclic load on fracture resistance of lower premolars obturated with AH Plus and BioRoot RCS root canal sealers. Forty-eight single-rooted premolars teeth were instrumented with REVO-S files up to SU/0.06 taper. The teeth were randomly assigned into 2 main groups (n = 24) according to the selected two root canal sealers (AH Plus or BioRoot RCS). All teeth were obturated using matching gutta-percha. Each main group were further divided into 3 subgroups (A, B and C) (n = 8). Group A acted as the negative control group (non-Thermomechanical aging). Whereas Group B and C were subjected first to thermal variations in a thermal cycling machine (7500 and 15,000 thermal cycles), then two different dynamic loading periods namely 3 × 105 and 6 × 105 in a masticatory simulator with a nominal load of 5 kg at 1.2 Hz which simulate approximately 1 ½ and 3 years of clinical function respectively. The roots were decoronated and fracture resistance were measured using a universal testing machine. After thermal-mechanical aging, BioRoot RCS showed significantly higher fracture resistance (p < 0.05) than AH Plus. As the thermal-mechanical cycles increased both AH Plus and BioRoot RCS exhibited a significant decrease in fracture resistance (p < 0.05). It could be concluded that thermomechanical aging had a significant impact on the outcome of the fracture resistance of AH Plus and BioRoot RCS.

This study investigated the possibility of re-treating a calcium silicate-based sealer (CSBS), compared to an epoxy-resin sealer (RBS), using rotary instrumentation at different times from obturation (1 month/1 year). Thirty-six human mandibular premolars, extracted as a result of orthodontic or periodontal problems, were instrumented and randomly divided into three groups of 12: BR and BR*, which were filled with CSBS and re-treated after one month and one year of storage, respectively, and AH, which was filled with RBS and re-treated after one month. The same re-treatment protocol was used for all teeth, and the times required for the procedure was recorded. The re-treated specimens were longitudinally sectioned and examined at the stereomicroscope (SM) at 20× magnification. Image J Software was used to process the microphotographs. The percentage of residual filling materials in the root canal and the apical third, the ability to reach working length WL and patency, and the time taken to complete the re-treatment were recorded and analyzed by ANOVA and post hoc Bonferroni test (p = 0.05). Scanning electron microscopy (SEM) and coupled energy-dispersive spectroscopy (EDS) were applied to representative samples to evaluate canal cleanliness and chemical elements. Patency and WL were re-established in all of the teeth. Residual filling materials were retained in all specimens of the three groups. The mean percentage of residual materials was significantly different between BR and BR* (p-value = 0.048), with BR* showing the highest values. The mean time to complete re-treatment was significantly lower for AH, followed by BR (p = 0.0001) and BR* (p = 0.0078). Conclusions: After both medium and long storage periods, the CSBS can be concluded to have been successfully removed from canals with simple anatomy. [ABSTRACT FROM AUTHOR]

Objective: To compare and evaluate the retreatability of calcium silicate-based root canal sealers and epoxy resin-based root canal sealers in curved canals using micro-CT scanning. Materials and Methods: Forty-five maxillary molars with curved roots were selected after confirming with the Schneiders test. Teeth were decoronated near the cemento-enamel junction and moderate to severely curved canals were selected for the study using cone-beam computed tomography. All the samples were subjected to pre-operative micro-CT scanning. Cleaning and shaping were done using step-back preparation, obturation was done using lateral compaction technique, and homogeneous obturation was achieved. All the specimens were kept in 10 mL of phosphate buffered-saline solution at a pH of 8.4 for 48 h and transferred to a plastic container containing moistened foam with 10 mL of phosphate- buffered saline solution, and stored at 37 °C with 100% relative humidity for 4 months. Retreatment was performed for all the samples using Protaper universal retreatment files. Micro-CT scanning was performed to compare and evaluate the remaining sealer volume and resultant cracks formed in the root canal after retreatment. Results: The volume of sealer remaining in the root canal and the length of a crack within the groups were analysed using kruskal–Wallis test and among the groups using post-hoc scheffe test showed that more sealer present in the Diaproseal sealer followed by MTA Fillapex and Bioroot RCS and more crack length was seen in Diaproseal sealer followed by MTA Fillapex and no visible cracks were seen in Bioroot RCS, which had statistically significant results with a P value of < 0.05. Conclusion: Within the limitations of the study it was concluded that in-terms of retrievability, Diaproseal sealer was the best among the tested groups followed by MTA Fillapex and Bioroot RCS.

This study compared the retreatability of filling material from canals filled with BioRoot RCS (Septodont, Saint‐Maur‐des‐Fosses, France) and AH Plus (Dentsply DeTrey, Konstanz, Germany) combined with gutta‐percha using micro‐computed tomography for evaluation. Thirty‐four mandibular premolars were divided into two groups according to the sealer used. Thirty days after obturation, canals were retreated with a ProTaper Universal retreatment system (Dentsply Maillefer, Ballaigues, Switzerland) followed by passive ultrasonic irrigation (PUI). The time taken for retreatment was recorded. The roots were scanned after obturation, after retreatment and after PUI. Data were analysed using the Mann–Whitney and Wilcoxon tests. Canals filled with BioRoot RCS exhibited significantly less remaining filling material than canals filled with AH Plus (P < 0.05). The addition of PUI resulted in a significant decrease in the residual material in both groups (P < 0.05). A significantly shorter retreatment time was reported for the AH Plus group than the BioRoot RCS group (P < 0.05). [ABSTRACT FROM AUTHOR]

Abstract Introduction: It has been observed that the teeth which got treated endodontically are getting fractured easily particularly when we compare it with vital teeth. In current obturation systems Gutta-percha which has the epoxy resin-based AH plus sealer, is considered the gold standard. Our aim here is to compare the AH Plus sealer effect with that of BioRoot RCS in reference to resistence of fracture when roots are getting filled with them in combination with gutta-percha. Method: Thirty extracted teeth are used. These teeth are without caries. These are single rooted too and at the same time human mandibular premolar. To store the teeth we used de ionized water whereas the temperature has be maintained at 4 °C. For fracture resistance test, roots were mounted in acrylic resin blocks. The middle third of each root was coated with uniform thickness of light body rubber base to provide a simulated periodontal ligament then each root was embedded in acrylic resin cylinder using self-cured acrylic resin except for the coronal 5 mm. Result: Bio Root RCS had the highest mean fracture resistance of 254.15N, followed by that of AH Plus group with a mean of 229.5 N, then that of the control group 200.40 N. Conclusion: The present study lead us to conclude that Bioroot RCS are higher fracture resistance than the AH Plus. [ABSTRACT FROM AUTHOR]

Background: According to the Glossary of the American Association of Endodontists, resorption is defined as a condition associated with either a physiologic or a pathologic process resulting in the loss of dentin, cementum, or bone. It may present internally (pulpal origin) or externally (periodontal origin). Internal resorption is a rare, insidious, resorptive pathological process, starting from the pulp extending into the surrounding dentin. Treatment is mainly focused on arresting the cellular activity accounting for the resorptive process. Methodology: A patient presented with an upper front tooth that was tender on percussion and a history of trauma in her childhood which resulted in Ellis class II fracture of the tooth. Pulp sensibility testing showed a negative response suggestive of a non-vital tooth. A non-surgical endodontic therapy was carried out under the microscope with calcium hydroxide dressings followed by the three-dimensional obturation technique using thermoplasticized Gutta percha. Conclusion: The current case report discusses the etiology and symptoms of internal inflammatory resorption, the contribution of cone beam computed tomography imaging in its diagnosis, and a step wise protocol for the three dimensional obturation of the resorptive lesion. [ABSTRACT FROM AUTHOR]

Background. This in vitro study compared the fracture resistance of roots instrumented either with ProTaper or One Shape rotary systems and filled with one of the silicate, epoxy resin or silicone-based sealers. Methods. Sixty single-rooted extracted mandibular premolars were decoronated to a length of 13 mm and then randomly divided into two main groups (n=30) in terms of the rotary system used for preparation. Group 1 samples were instrumented with the ProTaper Universal system up to a master apical file of #F2, while samples in group 2 were enlarged with One Shape system. The two main groups were then divided into 3 subgroups in terms of the sealer used (n=10) and filled with guttapercha (either F2 or MM-GP points) of the rotary system used and one of the sealers as follows: group 1, BioRoot RCS + ProTaper F2 gutta-percha; group 2, AH Plus + ProTaper F2 gutta-percha; group 3, GuttaFlow + ProTaper F2 gutta-percha; group 4, BioRoot RCS+ MM-GP points; group 5, AH Plus + MM-GP points; and group 6, GuttaFlow + MM-GP points. Each specimen then underwent fracture testing by using a universal testing machine at a crosshead speed of 1.0 mm/min until the root fractured. Data were statistically analyzed. Results. Two-way ANOVA showed no significant differences between the groups. One Shape instruments showed significantly better fracture resistance compared to ProTaper instruments. Statistically, no significant difference was found between AHPlus, GuttaFlow and BioRoot RCS sealers. Conclusion. It can be concluded that the rotary system used for the instrumentation of teeth has some influence on the fracture resistance, while the root canal sealers do not have such an effect.

This study investigated the possibility of re-treating a calcium silicate-based sealer (CSBS), compared to an epoxy-resin sealer (RBS), using rotary instrumentation at different times from obturation (1 month/1 year). Thirty-six human mandibular premolars, extracted as a result of orthodontic or periodontal problems, were instrumented and randomly divided into three groups of 12: BR and BR*, which were filled with CSBS and re-treated after one month and one year of storage, respectively, and AH, which was filled with RBS and re-treated after one month. The same re-treatment protocol was used for all teeth, and the times required for the procedure was recorded. The re-treated specimens were longitudinally sectioned and examined at the stereomicroscope (SM) at 20× magnification. Image J Software was used to process the microphotographs. The percentage of residual filling materials in the root canal and the apical third, the ability to reach working length WL and patency, and the time taken to complete the re-treatment were recorded and analyzed by ANOVA and post hoc Bonferroni test (p = 0.05). Scanning electron microscopy (SEM) and coupled energy-dispersive spectroscopy (EDS) were applied to representative samples to evaluate canal cleanliness and chemical elements. Patency and WL were re-established in all of the teeth. Residual filling materials were retained in all specimens of the three groups. The mean percentage of residual materials was significantly different between BR and BR* (p-value = 0.048), with BR* showing the highest values. The mean time to complete re-treatment was significantly lower for AH, followed by BR (p = 0.0001) and BR* (p = 0.0078). Conclusions: After both medium and long storage periods, the CSBS can be concluded to have been successfully removed from canals with simple anatomy.

Objective: To compare and evaluate the retreatability of calcium silicate-based root canal sealers and epoxy resin-based root canal sealers in curved canals using micro-CT scanning.Materials and Methods: Forty-five maxillary molars with curved roots were selected after confirming with the Schneiders test. Teeth were decoronated near the cemento-enamel junction and moderate to severely curved canals were selected for the study using cone-beam computed tomography. All the samples were subjected to pre-operative micro-CT scanning. Cleaning and shaping were done using step-back preparation, obturation was done using lateral compaction technique, and homogeneous obturation was achieved. All the specimens were kept in 10 mL of phosphate buffered-saline solution at a pH of 8.4 for 48 h and transferred to a plastic container containing moistened foam with 10 mL of phosphate- buffered saline solution, and stored at 37 °C with 100% relative humidity for 4 months. Retreatment was performed for all the samples using Protaper universal retreatment files. Micro-CT scanning was performed to compare and evaluate the remaining sealer volume and resultant cracks formed in the root canal after retreatment.Results: The volume of sealer remaining in the root canal and the length of a crack within the groups were analysed using kruskal-Wallis test and among the groups using post-hoc scheffe test showed that more sealer present in the Diaproseal sealer followed by MTA Fillapex and Bioroot RCS and more crack length was seen in Diaproseal sealer followed by MTA Fillapex and no visible cracks were seen in Bioroot RCS, which had statistically significant results with a P value of < 0.05.Conclusion: Within the limitations of the study it was concluded that in-terms of retrievability, Diaproseal sealer was the best among the tested groups followed by MTA Fillapex and Bioroot RCS. [ABSTRACT FROM AUTHOR]

Objectives: To compare the percentage of voids in matched-taper single-cone fillings with GuttaFlow Bioseal or BioRoot RCS root canal sealers, using micro-computed tomography. Materials and methods: Forty-eight single-rooted mandibular premolars were prepared using rotary files and randomly allocated into 2 groups (n = 24), wherein the canals were filled with a matched-taper single gutta-percha cone and one of the two sealers: Group 1, GuttaFlow Bioseal and Group 2, BioRoot RCS. The specimens were scanned with micro-CT before and after root canal filling. A specialized software was used to calculate the voids volume percentage (V%) in the filling for the whole root canal, root canal thirds, and the last millimeter from the apex. Data were statistically analyzed by ANOVA and Tukey tests (p < 0.05). Results: Root canals filled with GuttaFlow Bioseal had significantly less V% than those filled with BioRoot RCS in all the root-thirds (p < 0.05) except at the apical 1 mm (p > 0.05). Comparing the root-thirds, GuttaFlow Bioseal showed similar V% in all regions (p > 0.05), while BioRoot RCS group had significantly greater V% in the coronal third compared with the other thirds (p < 0.05). Conclusions: Root canals filled with a matched-taper single cone and GuttaFlow Bioseal had significant less voids than those with BioRoot RCS, except at the apical 1 mm. Clinical relevance: Voids in root fillings have been reported to have a negative impact on root canal treatment. This study highlights the percentage of voids in root fillings composed of a single cone of gutta-percha with two types of calcium silicate–based bioceramic sealers. [ABSTRACT FROM AUTHOR]

Abstract Background The aim was to compare the dislodgement resistance of calcium silicate-based sealers (Total Fill BC Sealer, Endo CPM Sealer, BioRoot RCS) with an epoxy resin-based sealer (AH Plus). Methods The root canals of 80 single-rooted human teeth were instrumented with F360 up to size 45.04. All canals were obturated using matching gutta-percha cones according to the single-cone technique in combination with one of the mentioned sealers (n = 20 per group). After eight weeks of incubation (37 °C, 100% humidity), the roots were embedded in resin. Starting with a distance of 7 mm from the apex, four slices of 1 mm thickness were cut. Dislodgement resistance was measured using a universal testing machine and the push-out bond strength was calculated. Specimens were examined under 4×-magnification to determine the mode of bond failure. Statistical analysis was performed using ANOVA and Student-Newman-Keuls-test. Results Regarding the pooled data of all sections, the push-out bond strength of AH Plus was significantly higher than the push-out bond strength of all calcium silicate-containing sealers (P

The purpose of this study was to compare the speed of removal of root canal filling material and re-establishment of apical patency in root canals filled with a tricalcium silicate–based sealer (BioRoot RCS [BRCS]; Septodont, Saint-Maur-des-Fossés, France) versus a zinc oxide–eugenol sealer (Pulp Canal Sealer [PCS]; Sybron Endo Kerr, Orange, CA) and to analyze the effect of the operator's experience. One hundred twenty root canals of 40 Dentalike dental simulators (Dentsply Sirona, York, PA) were shaped with a WaveOne (Dentsply Sirona) reciprocating file using short 3-mm strokes. Root canals were obturated using a single gutta-percha cone and either BRCS or PCS. Samples treated either with BRCS or PCS were equally dispatched between experienced practitioners and junior practitioners. The time required to remove root filling material and establish apical patency was recorded for each root canal. Samples were compared according to the sealer used and the practitioner's experience (Mann-Whitney test). One hundred fifteen root canals were successfully retreated. No differences in the time required to remove the filling material were observed between the 2 materials for mesiobuccal or distobuccal canals (P >.05). In contrast, the procedure was longer for palatal canals filled with BRCS compared with PCS (79.10 vs 182.45 seconds, P <.01). Experienced practitioners took significantly less time than junior practitioners (P <.05). BRCS can be successfully removed from root canals as quickly as a zinc oxide–eugenol sealer in both mesiobuccal and distobuccal canals but not in palatal ones. The duration of the procedure was affected by the operator's experience independent of the filling material used or the canal type. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the suitability of rhodamine B dye staining of an epoxy resin sealer (AH Plus) and calcium-silicate-based sealers (Total Fill BC Sealer, BioRoot RCS) to represent the penetration depth of the sealers into dentinal tubules after root canal obturation. In a three-step process, (1) leaching of rhodamine B from sealers into a buffer solution, (2) passive penetration of leached rhodamine B into dentinal tubules, and (3) conformity of rhodamine B penetration assessed by confocal laser scanning microscopy (CLSM), and sealer penetration assessed by scanning electron microscopy (SEM), in root-canal-filled teeth, were evaluated. Rhodamine B dye massively leached out of Total Fill BC Sealer and BioRoot RCS into the phosphate-buffered saline (PBS). A pinkish coloration of AH Plus was found after contact with PBS. Leached rhodamine B dye passively penetrated dentinal tubules from all three sealers when placed on root dentin. No correlation was observed between sealer penetration in SEM and rhodamine B penetration in CLSM. Staining of sealers using rhodamine B is an inadequate method with which to evaluate sealer penetration depth into dentinal tubules, as it overestimates the penetration of sealers into root dentin tubules.

Aim: The aim of this present study was to compare the dislodgement resistance of calcium silicate-based sealer, zinc oxide sealer, and a new sealer combining both zinc oxide and calcium silicate-based sealer in vitro ., Materials and Methods: 60 single-rooted human teeth were instrumented with F3 Protaper Gold. All endodontic canals were filled using gutta percha cones using the cold lateral condensation technique in combination using one of the mentioned sealers ( n  = 20 per group). The teeth were divided into three groups: group A consisted of Sealite® Ultra, group B consisted of K-Sealer®, and group C consisted of BioRoot® RC. After 2 months of incubation (37°C, 100% humidity) and after cutting out 2 mm from the most apical portion of the root apex, six slices of 1 mm thickness were generated. Mechanical dislodgement resistance was examined using a universal pressure-testing machine and the push-out bond strength (POBS) was calculated. Specimens were examined under 20× magnification to define the bond failure mode. Statistical analysis was executed using ANOVA, post hoc Turkey test for pairwise comparisons and Kruskal-Wallis tests., Results: The POBS of BioRoot® was significantly higher than the POBS of the two other sealers with a mean of 10.54 MPa ± 2.10 and 5.73 MPa ± 2.34, respectively ( p  < 0.001). Sealite® and K-Sealer® showed similar results in the median and coronal part. K-Sealer® revealed highest POBS compared with Sealite® in the apical part ( p  < 0.05)., Conclusion: The POBS of the zinc oxide and calcium silicate-based sealer was significantly lower compared with calcium silicate. Sealite® and K-Sealer® exhibited almost same results. BioRoot showed the highest POBS of all sealers., Clinical Significance: The current study was needed to evaluate the bond strength of three different cements to dentinal walls, by evaluating their respective POBS in vitro . The findings of this study may provide guidance for the clinician in the selection of an adequate endodontic sealer that guarantees an enhanced adhesive seal between the Gutta-percha and the dentinal canal walls. How to cite this article: Makhlouf MP, El Helou JD, Zogheib CE, et al . Comparative Evaluation of Push-out Bond Strength of Three Different Root Canal Sealers: An In Vitro Study. J Contemp Dent Pract 2024;25(1):15-19.

Aim: To investigate the retreatability of two calcium silicate‐based materials (BioRoot RCS, Septodont, Saint–Maur‐des‐Fossés, France and GuttaFlow Bioseal, Colténe/Whaledent AG, Langenau, Germany) using rotary instrumentation combined with supplementary irrigant agitation techniques using extracted teeth in a laboratory setting. Methodology: The root canals of extracted single‐rooted mandibular premolars were prepared to size 40,.04 taper and randomly divided into two experimental groups (n = 36) depending on the root filling material. Root canals were filled with gutta‐percha and GuttaFlow Bioseal (GB, group 1) or BioRoot RCS (BR, group 2), scanned using a micro‐CT scanner and stored in phosphate‐buffered saline for 4 months. Removal of root filling was performed with rotary instruments, and specimens were randomly allocated to one of the subgroups for supplementary irrigant agitation (n = 12): subgroup A, syringe irrigation (control); subgroup B, Tornado Brush (M.I.B, Suresnes, France) and subgroup C, ultrasonically activated irrigation. Specimens were re‐scanned with micro‐CT to calculate the volume of remnant root filling material. Data were analysed statistically by two‐way ANOVA and post hoc Tukey's tests (P = 0.05). Results: Specimens filled with GuttaFlow Bioseal were associated with a significantly smaller volume of root filling remnants compared with BioRoot RCS (P < 0.05). There was no significant difference between the supplementary irrigant agitation subgroups in the removal of GB (P > 0.05). In group 2 (BioRoot RCS), subgroups B (Tornado Brush) and C (ultrasonically activated irrigation) were associated with a significantly smaller volume of root filling remnants compared with subgroup A (syringe irrigation) (P < 0.05). There was no significant difference between subgroups B and C (P > 0.05). Conclusions: Significantly smaller volumes of root filling remnants of GuttaFlow Bioseal, than BioRoot RCS, were present after their removal with rotary instruments and irrigation. Supplementary irrigant agitation techniques were associated with smaller volumes of remnants during the removal of BioRoot RCS but not that of GuttaFlow Bioseal. [ABSTRACT FROM AUTHOR]

Background. This in vitro study compared the fracture resistance of roots instrumented either with ProTaper or One Shape rotary systems and filled with one of the silicate, epoxy resin or silicone-based sealers. Methods. Sixty single-rooted extracted mandibular premolars were decoronated to a length of 13 mm and then randomly divided into two main groups (n=30) in terms of the rotary system used for preparation. Group 1 samples were instrumented with the ProTaper Universal system up to a master apical file of #F2, while samples in group 2 were enlarged with One Shape system. The two main groups were then divided into 3 subgroups in terms of the sealer used (n=10) and filled with gutta-percha (either F2 or MM-GP points) of the rotary system used and one of the sealers as follows: group 1, BioRoot RCS + ProTaper F2 gutta-percha; group 2, AH Plus + ProTaper F2 gutta-percha; group 3, GuttaFlow + ProTaper F2 gutta-percha; group 4, BioRoot RCS+ MM-GP points; group 5, AH Plus + MM-GP points; and group 6, GuttaFlow + MM-GP points. Each specimen then underwent fracture testing by using a universal testing machine at a crosshead speed of 1.0 mm/min until the root fractured. Data were statistically analyzed. Results. Two-way ANOVA showed no significant differences between the groups. One Shape instruments showed significantly better fracture resistance compared to ProTaper instruments. Statistically, no significant difference was found between AHPlus, GuttaFlow and BioRoot RCS sealers. Conclusion. It can be concluded that the rotary system used for the instrumentation of teeth has some influence on the fracture resistance, while the root canal sealers do not have such an effect. [ABSTRACT FROM AUTHOR]

The aim was to evaluate the influence of different irrigation solutions on the push-out bond strength (POBS) of three different sealers (AH Plus, BioRoot RCS, GuttaFlow2). Root canals of 180 single-rooted human teeth were instrumented with F360 up to size 45.04. All canals were irrigated with 5 ml NaOCl 3% and 5 ml EDTA 17%. The canals were finally irrigated with either 5 ml NaOCl 3%, CHX 2%, EDTA 17%, citric acid 20% or NaCl 0.9% (n = 36) with a contact time of 5 min and obturated using matching gutta-percha cones according to the single-cone technique in combination with one of the sealers (n = 12). After 8 weeks of incubation, the roots were embedded in resin. Two slices of 1 mm thickness were obtained representing the middle third of the root. Dislodgement resistance was measured and POBS was calculated. Specimens were examined under 4× magnification to determine the mode of bond failure. Statistical analysis was performed using two-way ANOVA and Student–Newman–Keuls test for POBS and Chi-square test for the mode of failure. POBS was significantly affected by the factor "sealer" (P < 0.001) and by the interaction "sealer/irrigation solution" (P < 0.01). AH Plus revealed significantly higher POBS than BioRoot RCS and GuttaFlow2 (P < 0.05). The POBS of GutttaFlow2 was not affected by the irrigation protocol (P > 0.05). The POBS of AH Plus was positively influenced by EDTA and NaOCl. EDTA had a negative effect on the POBS of BioRoot RCS. The POBS of GuttaFlow2 was not influenced by the irrigation solutions. [ABSTRACT FROM AUTHOR]

The aim of this study was to gain information about the effect of thermal treatment of calcium silicate-based sealers. BioRoot RCS (BR), Total Fill BC Sealer (TFBC), and Total Fill BC Sealer HiFlow (TFHF) were exposed to thermal treatment at 37 °C, 47 °C, 57 °C, 67 °C, 77 °C, 87 °C and 97 °C for 30 s. Heat treatment at 97 °C was performed for 60 and 180 s to simulate inappropriate application of warm obturation techniques. Thereafter, specimens were cooled to 37 °C and physical properties (setting time/flow/film thickness according to ISO 6876) were evaluated. Chemical properties (Fourier-transform infrared spectroscopy) were assessed after incubation of the specimens in an incubator at 37 °C and 100% humidity for 8 weeks. Statistical analysis of physical properties was performed using the Kruskal-Wallis-Test (P = 0.05). The setting time, flow, and film thickness of TFBC and TFHF were not relevantly influenced by thermal treatment. Setting time of BR decreased slightly when temperature of heat application increased from 37 °C to 77 °C (P < 0.05). Further heat treatment of BR above 77 °C led to an immediate setting. FT-IR spectroscopy did not reveal any chemical changes for either sealers. Thermal treatment did not lead to any substantial chemical changes at all temperature levels, while physical properties of BR were compromised by heating. TFBC and TFHF can be considered suitable for warm obturation techniques.

Abstract Introduction The aim of this study was to compare the solubility and the change in pH of a tricalcium silicate–containing sealer (BioRoot RCS [BR]), a mineral trioxide aggregate–containing sealer (MTA Fillapex [MTA]), and an epoxy resin–based sealer (AH Plus [AH]) during a longer period of time. Methods The solubility test was carried out in accordance with ISO6876:2012. Three hundred eighty sealer samples (n = 10 per group) were stored for 6 months in double distilled water (AD) or phosphate-buffered saline (PBS). The solubility was determined on the basis of the mass difference in percent. The pH measurement was carried out on the basis of the experimental setup of the solubility test with the aid of an electrode pH meter. The results were evaluated for significance by using analysis of variance, Student-Newman-Keuls, and t test (P <.05). Results The highest solubility was found for MTA in AD (4.65% ± 1.17%), followed by BR in AD (3.88% ± 0.42%) (P <.05). Also in PBS, MTA (3.24% ± 0.7%) showed a higher solubility than BR (1.78% ± 0.5%) (P <.05). AH was virtually insoluble during the entire period (0.5% ± 0.5%) (P <.05). The pH decreased continuously over time for all samples. After 6 months, BR showed the highest pH in AD (pH 10.3), followed by MTA in AD (pH 8.8), BR in PBS (pH 7.5), AH in PBS (pH 7.3), MTA in PBS (pH 7.2), and AH in AD (pH 6.3). Conclusions The solubility of MTA was significantly increased compared with BR and AH. Storage in PBS significantly reduced solubility of MTA and BR. BR showed a higher pH in both AD and PBS than MTA in AD and PBS. AH did not cause any significant pH change. Highlights • This is the first study evaluating the solubility and pH of sealers for 6 months. • BioRoot RCS and MTA Fillapex were compared with AH Plus. • The solubility for BioRoot RCS and MTA Fillapex was significantly lower in PBS. • Despite a lower solubility of BioRoot RCS compared to MTA Fillapex, the pH BioRoot RCS was higher. [ABSTRACT FROM AUTHOR]

Introduction Resin sealers with biocompatible and bioactive additives have been used in clinical practice. Recently, a calcium silicate root canal sealer was introduced under the name BioRoot RCS (Septodont, Saint Maur-des-Fossés, France). The aim of this study was to evaluate the effects of BioRoot RCS on cell survival and proliferation of cultured cells in parallel with an epoxy resin sealer with calcium phosphate and calcium oxide and a salicylate resin sealer with mineral trioxide aggregate filler. The tested hypothesis was that BioRoot RCS is significantly less cytotoxic than the other tested sealers. Methods The experiments were performed on NIH/3T3 cells (American Type Culture Collection, Manassas, VA) grown as monolayer cultures at 37°C in atmosphere containing 5% CO 2 in air and 100% relative humidity. The sealers' extracts (24 hours and 1 week) were applied to cells at 1:1 and 1:2 dilutions. The effect was assessed by a modified sulforhodamine B staining assay in reference to controls after 24 and 72 hours of exposure. All experiments were performed at least twice in 6 replicates. Analysis of variance and post hoc comparison tests were used to evaluate the statistical significance of the results at a level of significance of P = .05. Results BioRoot RCS was significantly less cytotoxic than the other 2 sealers. MTA-Fillapex (Angelus, Londrina, Brazil) and SimpliSeal (Discuss Dental, LLC, Calver City, CA) exhibited a similar antiproliferative profile with no statistically significant differences in all settings. Conclusions BioRoot RCS showed quite a positive biological behavior. Further investigation is needed in order to clarify the mechanism and the components that contribute to the beneficial results observed. [ABSTRACT FROM AUTHOR]

Aim To evaluate the chemical and physical properties of a tricalcium silicate root canal sealer containing povidone and polycarboxylate (BioRoot RCS), a calcium silicate MTA-based sealer containing a salicylate resin (MTA Fillapex), a traditional eugenol-containing sealer (Pulp Canal Sealer) and an epoxy resin-based root canal sealer (AH Plus). Methodology Calcium release, pH, setting time, water sorption, volume of open pores, volume of impervious portion, apparent porosity and weight loss were measured. The ability to nucleate calcium phosphates (CaP) after ageing 28 days in a simulated body fluid was evaluated using ESEM-EDX and micro-Raman spectroscopy. Data were statistically analysed ( P = 0.05) using one-way anova (setting time, radiopacity, solubility, water sorption, porosity) or two-way anova (ion release tests). Results BioRoot RCS had a final setting time of 300 min and adequate radiopacity (5.2 mm Al). It demonstrated the highest ( P < 0.05) and more prolonged ability to release calcium ions (721 ppm at 3 h) and to increase the pH (11-12) ( P < 0.05); B-type carbonated apatite deposits were found on aged BioRoot RCS (biointeractivity-related CaP-forming ability). A final setting time of 270 min and good calcium release (17.4 ppm at 3 h) were measured for MTA Fillapex; apatite deposits were present on aged samples. No calcium release and no alkalizing activity were measured for Pulp Canal Sealer and AH Plus; no CaP nucleation was detected on aged Pulp Canal Sealer, and some apatite deposits were found on aged AH Plus (chemi/physisorption-related CaP-deposition). Higher and significantly different ( P < 0.05) porosity, water sorption and solubility were measured for the two calcium silicate sealers, especially for BioRoot RCS. Conclusions BioRoot RCS had bioactivity with calcium release, strong alkalizing activity and apatite-forming ability, and adequate radiopacity. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the influence of immersion duration and the type of immersion solution on the outcome of push-out bond strength (POBS) tests. Root canals of 120 straight single-rooted teeth were instrumented to a diameter of 1.5 mm and irrigated with 5 mL of 3% NaOCl. Four horizontal slices with a thickness of 1 mm were cut, representing the mid-portion of the root. The specimens (n = 480) were irrigated with 17% ethylenediaminetetraacetic acid(EDTA) for 60 seconds, then twice with distilled water (DW) for 30 s each. The canals were filled with either AH Plus (Dentsply Sirona, Konstanz, Germany) or BioRoot RCS (Septodont, St. Maur-des-Fossés, France) (n = 240). Separated into four groups per type of sealer (n = 60), the specimens were incubated at 37 °C covered with gauze moistened in DW or phosphate-buffered saline (PBS) for either one or eight weeks. Dislodgement resistance was measured and POBS was calculated. Statistical analysis was performed using the analysis of variance (ANOVA) test and the Student−Newman−Keuls test (p = 0.05). AH Plus showed higher POBS when stored in PBS compared to DW, irrespective of the incubation period (p < 0.05). BioRoot RCS displayed higher POBS when stored in DW compared to PBS after eight weeks of incubation (p < 0.05). No difference was found after one week of incubation (p > 0.05). Irrespective of the sealer or the immersion solution, POBS decreased from one week to eight weeks (p < 0.05). Mixed failure modes were found in all groups irrespective of sealer, immersion medium, or immersion period. POBS decreased after a longer incubation time in both immersion solutions. Duration of immersion and the type of immersion solution had a significant impact on the outcome of the POBS testing protocol.

The present study evaluated the porosity distribution of BioRoot RCS/single gutta-percha point (BR/SC) and MTA flow (MF) fillings, which were used as plugs for the apical perforation repair in curved canals of extracted mandibular molars using micro-computed tomography (μCT). Forty mesial root canals of mandibular first molars were shaped with ProTaper NEXT X1−X5 files 2 mm beyond the apex to simulate apical perforations that were randomly divided into two groups (n = 20) according to the material and technique used for the apical plug: BR/SC or MF. The specimens were scanned before and after canal filling at an isotropic resolution of 9.9 μm. The volumetric analysis of voids in the apical 5 mm of the fillings was performed. Data were analyzed using one-way ANOVA with Bonferroni correction (p < 0.05). Micro-computed tomography (µCT) evaluation revealed significant differences between the groups in terms of porosity: the total volume and percentage volume of voids was lower in the BR/SC group in comparison with the MF group (p < 0.05), with the predominance of open pores in both groups. Neither of the materials and/or application techniques were able to produce void-free root fillings in the apical region of artificially perforated curved roots of mandibular molars.

Introduction The aim was to compare the solubility, radiopacity, and setting times of a tricalcium silicate–containing (BioRoot RCS; Septodont, St Maur-des-Fossés, France) and a mineral trioxide aggregate–containing sealer (MTA Fillapex; Angelus, Londrina, Brazil) with an epoxy resin–based sealer (AH Plus; Dentsply DeTrey, Konstanz, Germany). Methods Solubility in distilled water, radiopacity, and setting time were evaluated in accordance with ISO 6876:2012. The solubility was also measured after soaking the materials in phosphate-buffered saline buffer (PBS). All data were analyzed using 1-way analysis of variance and the Student-Newman-Keuls test. Results After immersion for 1 minute in distilled water, BioRoot RCS was significantly less soluble than AH Plus and MTA Fillapex ( P < .05). At all other exposure times, AH Plus was significantly less soluble than BioRoot RCS, whereas BioRoot RCS was significantly more soluble than the other 2 sealers ( P < .05). All sealers had the same solubility in PBS and distilled water, except for BioRoot RCS after 28 days. At this exposure time, BioRoot RCS was significantly less soluble in PBS than in distilled water and less soluble than MTA Fillapex ( P < .05). All BioRoot RCS specimens immersed in PBS had a surface precipitate after 14 and 28 days. The radiopacity of all sealers was greater than 3 mm aluminum with no statistical significant difference between the sealers ( P > .05). The final setting time was 324 (±1) minutes for BioRoot RCS and 612 (±4) minutes for AH Plus. The difference was statistically significant ( P < .05). MTA Fillapex did not set completely even after 1 week. Conclusions The solubility and radiopacity of the sealers were in accordance with ISO 6876:2012. PBS decreased the solubility of BioRoot RCS. [ABSTRACT FROM AUTHOR]

This study assessed the dose-dependent effect on the cytotoxicity of BioRoot RCS (BR) and Endosequence BC (BC) sealers in human bone marrow mesenchymal stem cells (hMSCs) compared to those of the AH Plus sealer. Cells were exposed to different dilutions of extracts from freshly prepared sealers (1:2, 1:8, 1:32). Unexposed cells acted as the negative control. Cytotoxicity was evaluated by an alamar blue assay. Cell morphology was analyzed by using scanning electron microscopy after exposure to the different sealers’ extracts. Statistical analysis was performed using a one-way analysis of variance and the Bonferroni post hoc test (p < 0.05). The cytotoxicities of BC and BR were less than that of AH Plus. In the presence of 1:2 BR, the cell proliferation was significantly lower than the control. At 1:8 and 1:32 concentrations, both the tricalcium silicate sealers led to similar cellular proliferation. Cells in BC and BR sealers’ extracts spread better than those in AH Plus extract.

The aim of thisex vivostudy was to evaluate the vertical-fracture resistance of roots obturated with a newly developed tricalcium silicate cement (BioRoot RCS; Septodont, Saint Maur Des Fosses, France) using cold lateral compaction technique (LC) or matched-taper single-cone gutta-percha technique (SC). Decoronated 82 single-rooted mandibular premolars were chemo-mechanically prepared and then randomly divided into 6 experimental groups (n = 12) and 2 control groups (n = 5): Group 1 iRoot SP-LC; Group 2 iRoot SP-SC; Group 3 MTA Fillapex-LC; Group 4 MTA Fillapex-SC; Group 5 BioRoot RCS-LC and Group 6 BioRoot RCS-SC. In the positive-control group, roots were instrumented but not filled, and in the negative-control group, roots were neither instrumented nor filled. All samples were incubated for two weeks and then subjected to vertical loading force (1 mm/min) until fracture. The force required to fracture each specimen were determined, and the data were statistically analyzed. The highest significant fracture resistance was recorded for the iRoot SP-LC, iRoot SP-SC, BioRoot RCS-LC, and BioRoot RCS-SC groups, with no significant difference among them (p > 0.05) when compared with the positive-control group (p < 0.05), whereas the lowest significant values were observed in the MTA Fillapex-LC and MTA Fillapex-SC groups (p < 0.05). The vertical fracture resistance of roots obturated with BioRoot RCS and iRoot SP sealers using either LC or SC technique was found to be similar to that of intact teeth. BioRoot RCS, newly developed tricalcium silicate cement, might have the potential to reinforce the instrumented teeth against vertical root fracture. [ABSTRACT FROM AUTHOR]

Introduction Sealers based on tricalcium silicate cement aim at an interaction of the sealer with the root canal wall, alkalinity with potential antimicrobial activity, and the ability to set in a wet field. The aim of this study was to characterize and investigate the properties of a new tricalcium silicate–based sealer and verify its compliance to ISO 6876 (2012). Methods A new tricalcium silicate–based sealer (Bio MM; St Joseph University, Beirut, Lebanon), BioRoot RCS (Septodont, St Maure de Fosses, France), and AH Plus (Dentsply, DeTrey, Konstanz, Germany) were investigated. Characterization using scanning electron microscopy, energy-dispersive spectroscopy, and X-ray diffraction analysis was performed. Furthermore, sealer setting time, flow, film thickness, and radiopacity were performed following ISO specifications. pH and ion leaching in solution were assessed by pH analysis and inductively coupled plasma. Results Bio MM and BioRoot RCS were both composed of tricalcium silicate and tantalum oxide in Bio MM and zirconium oxide in BioRoot RCS. In addition, the Bio MM contained calcium carbonate and a phosphate phase. The inorganic components of AH Plus were calcium tungstate and zirconium oxide. AH Plus complied with the ISO norms for both flow and film thickness. BioRoot RCS and Bio MM exhibited a lower flow and a higher film thickness than that specified for sealer cements in ISO 6876. All test sealers exhibited adequate radiopacity. Conclusions Bio MM interacted with physiologic solution, thus showing potential for bioactivity. Sealer properties were acceptable and comparable with other sealers available clinically. [ABSTRACT FROM AUTHOR]

Aim To investigate the ability of BioRoot RCS, a tricalcium silicate-based root canal sealer and AH Plus to effectively fill the root canals of contralateral teeth using three evaluation methods, and to investigate also the correlation between the methods. Methodology The prepared root canals of ten pairs of contralateral mandibular premolar teeth were filled with gutta-percha and sealer using lateral compaction. The percentage of voids within the root canal was assessed by micro-computed tomography, whilst sealing ability was investigated by fluid transport and leakage of fluorescent microspheres. The interaction of sealer with dentine, and sealer penetration were assessed by confocal microscopy. The void volume, fluid flow, microsphere leakage and sealer interaction with dentine for both materials were compared. Nonparametric (Mann-Whitney) tests were used to compare the % void and fluid transport of the two sealers. Spearman correlation was used to assess the pairwise relationships between the techniques. The level of significance was set to 0.05. Results BioRoot RCS exhibited significantly more percentage of voids than AH Plus. There was no difference in fluid flow and microsphere penetration. BioRoot RCS exhibited a different pattern of sealer penetration and interaction with the dentine walls compared to AH Plus. For both materials, the pairwise correlations between the three techniques were close to zero, indicating weak relationships. Conclusions Micro CT analysis revealed a higher void volume for BioRoot RCS. The other techniques did not show a difference between the sealing ability of the sealers. The correlation between the three ex vivo methods of assessment was weak demonstrating their complementarity rather than their concordance. [ABSTRACT FROM AUTHOR]