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This in vitro study evaluated the sealing ability and microleakage of calcium silicate-based sealers compared to an epoxy resin-based sealer. One hundred twenty-five roots from anterior teeth were chemo-mechanically prepared and divided into four groups: AH Plus (AH), ProRoot MTA (PR), Medcem MTA (MC), and Total Fill BC Sealer/BC-coated gutta-percha (TF); n = 30. Confocal laser scanning microscopy was used to measure sealer penetration at three horizontal levels in 10 roots per group, while glucose leakage over 30 days was assessed in 20 roots. A lateral compaction technique was used for most groups, except for TF, which employed a single-cone method. Data were analyzed using Python with a Kruskal–Wallis test and Dunn's post hoc test. TF showed significantly greater penetration in the coronal and middle sections, while PR had the least penetration in the apical section. PR exhibited the highest canal circumference penetration, especially compared to MC and TF. Glucose leakage increased over time in all groups, with TF showing the highest permeability after 30 days. Overall, calcium silicate-based sealers PR, MC, and TF performed similarly to the epoxy resin standard AH, with all groups exhibiting decreasing penetration from coronal to apical and increased leakage over time. [ABSTRACT FROM AUTHOR]

The aim of the present in vitro study was to evaluate specific mechanical and physicochemical properties of three calcium silicate-based sealers, BioRoot™ Flow (BRF), CeraSeal (CRS) and TotalFill® (TF). Samples were prepared to evaluate different physicochemical and mechanical properties of the tested sealers. These evaluations were accomplished by investigating the pH changes over time, porosity, roughness, flow properties, compressive strength and wettability. The results were statistically evaluated using one-way analysis of variance. All three sealers demonstrated an alkaline pH from 1 h of immersion in water to 168 h. A higher porosity and hydrophily were detected in BRF samples compared to CRS and TF. No significant difference was found between the tested materials in the flow properties. Lower compressive strength values were observed for BRF compared to TF and CRS. Differently shaped structures were detected on the three materials after 7 days of immersion in PBS. The three materials demonstrated a higher solubility than 3% after 24 h of immersion in water (CRS < BRF < TF). The novel premixed calcium silicate sealer (BRF) had comparable physicochemical properties to the existing sealers. The lower compressive strength values could facilitate the removal of these materials during retreatment procedures. Further studies should investigate the biological effects of the novel sealer. [ABSTRACT FROM AUTHOR]

This in vitro study evaluated the sealing ability and microleakage of calcium silicate-based sealers compared to an epoxy resin-based sealer. One hundred twenty-five roots from anterior teeth were chemo-mechanically prepared and divided into four groups: AH Plus (AH), ProRoot MTA (PR), Medcem MTA (MC), and Total Fill BC Sealer/BC-coated gutta-percha (TF); n = 30. Confocal laser scanning microscopy was used to measure sealer penetration at three horizontal levels in 10 roots per group, while glucose leakage over 30 days was assessed in 20 roots. A lateral compaction technique was used for most groups, except for TF, which employed a single-cone method. Data were analyzed using Python with a Kruskal–Wallis test and Dunn’s post hoc test. TF showed significantly greater penetration in the coronal and middle sections, while PR had the least penetration in the apical section. PR exhibited the highest canal circumference penetration, especially compared to MC and TF. Glucose leakage increased over time in all groups, with TF showing the highest permeability after 30 days. Overall, calcium silicate-based sealers PR, MC, and TF performed similarly to the epoxy resin standard AH, with all groups exhibiting decreasing penetration from coronal to apical and increased leakage over time.

There is ample published literature regarding the technical aspects of restoring root‐filled teeth, but little concerning the biological impacts, consequences, and criteria for the selection of direct restorative materials following endodontic treatment. The provision of an effective coronal seal in addition to a sound root filling is known to be important in the prevention of root canal infection. This review seeks to explore the evidence concerning the selection of dental materials in the restoration of root‐filled teeth, specifically with a close examination of the properties of commonly used materials as orifice barriers. © 2023 Australian Dental Association. [ABSTRACT FROM AUTHOR]

Inflammation is a crucial step prior to healing, and the regulatory effects of endodontic materials on the immune response can influence tissue repair. This review aimed to answer whether endodontic sealers can modulate the immune cells and inflammation. An electronic search in Scopus, Web of Science, PubMed, and Google Scholar databases were performed. This systematic review was mainly based on PRISMA guidelines, and the risk of bias was evaluated by SYRCLEs and the Modified CONSORT checklist for in vivo and in vitro studies, respectively. In total, 28 articles: 22 in vitro studies, and six in vivo studies were included in this systematic review. AH Plus and AH 26 can down-regulate iNOS mRNA, while S-PRG sealers can down-regulate p65 of NF-κB pathways to inhibit the production of TNF-α, IL-1, and IL-6. In vitro and in vivo studies suggested that various endodontic sealers exhibited immunomodulatory impact in macrophages polarization and inflammatory cytokine production, which could promote healing, tissue repair, and inhibit inflammation. Since the paradigm change from immune inert biomaterials to bioactive materials, endodontic materials, particularly sealers, are required to have modulatory effects in clinical conditions. New generations of endodontic sealers could hamper detrimental inflammatory responses and maintain periodontal tissue, which represent a breakthrough in biocompatibility and functionality of endodontic biomaterials. [ABSTRACT FROM AUTHOR]

The ability of a substance to cause harm to the DNA molecule is known as genotoxicity. Because there is significant evidence of link between genetic damage and carcinogenesis, determining the real health hazards to patients and dental workers requires a thorough examination of genotoxicity caused by various dental materials. The aim of this paper is to provide a thorough overview of the genotoxicity induced by various endodontic materials. A systematic electronic search and screening of reference list were undertaken until November 2019. A meticulous search confined to English language articles was carried out in PubMed, Web of Science, and Scopus databases from their inception. The electronic search method retrieved 338 papers after the removal of duplicates, only 25 papers met the inclusion requirements following a thorough review of the findings. All evidence of genotoxicity has been found in the literature notably in relation to bleaching agents, restorative materials, and resin-based sealers. Such data will definitely be included to that already established for regulatory purposes as a secure way to enhance oral healthcare and avoid oral carcinogenesis. Reported information of genotoxicity induced by various endodontic materials is crucial for validating their safety in clinical practice as well as for identifying potential gaps in knowledge that must be studied further in future studies.

The success of endodontic treatment relies on both apical and coronal sealing. To achieve a good three-dimensional seal, the removal of the smear layer becomes mandatory. This study aims to assess the difference in debris accumulation and smear layer formation while using automated root canal irrigation and conventional syringe needle irrigation. Single-rooted human mandibular premolar teeth (n = 30) which were indicated for orthodontic extractions were selected. An endodontic access cavity was prepared, and a glide path was created. Based on the irrigation protocol decided upon for the study, the teeth were randomly allocated into three study groups, namely Group 1, where the manual syringe needle irrigation method was adopted; Group 2, in which automated root canal irrigation was undertaken; and Group 3, in which teeth remained un-instrumented as it was considered the Control group. The teeth were decoronated at the cement-enamel junction (CEJ) and were subjected for scanning electron microscopy (SEM) examination. Debris and smear layers were viewed in 1000× magnification and scored. A statistically significant (p < 0.05) lower mean debris and smear layer score (p < 0.05) was observed in both study groups when compared with the control group. However, no significant difference (p > 0.05) in the debris and smear layer was observed between the manual syringe needle irrigation and automated irrigation, although automated irrigation devices can be a potential alternative. The present study concluded that the efficacy of smear layer removal remained the same with both automated irrigation and manual syringe irrigation. [ABSTRACT FROM AUTHOR]

Materials used for endodontics and with direct contact to tissues have a wide range of indications, from vital pulpal treatments to root filling materials and those used in endodontic surgery. In principle, interaction with dental materials may result in damage to tissues locally or systemically. Thus, a great variety of test methods are applied to evaluate a materials' potential risk of adverse biological effects to ensure their biocompatibility before commercialization. However, the results of biocompatibility evaluations are dependent on not only the tested materials but also the test methods due to the diversity of these effects and numerous variables involved. In addition, diverse biological effects require equally diverse assessments on a structured and planned approach. Such a structured assessment of the materials consists of four phases: general toxicity, local tissue irritation, pre‐clinical tests and clinical evaluations. Various types of screening assays are available; it is imperative to understand their advantages and limitations to recognize their appropriateness and for an accurate interpretation of their results. Recent scientific advances are rapidly introducing new materials to endodontics including nanomaterials, gene therapy and tissue engineering biomaterials. These new modalities open a new era to restore and regenerate dental tissues; however, all these new technologies can also present new hazards to patients. Before any clinical usage, new materials must be proven to be safe and not hazardous to health. Certain international standards exist for safety evaluation of dental materials (ISO 10993 series, ISO 7405 and ISO 14155‐1), but researchers often fail to follow these standards due to lack of access to standards, limitation of the guidelines and complexity of new experimental methods, which may cause technical errors. Moreover, many laboratories have developed their testing strategy for biocompatibility, which makes any comparison between findings more difficult. The purpose of this review was to discuss the concept of biocompatibility, structured test programmes and international standards for testing the biocompatibility of endodontic material biocompatibility. The text will further detail current test methods for evaluating the biocompatibility of endodontic materials, and their advantages and limitations. [ABSTRACT FROM AUTHOR]

Inflammation is a crucial step prior to healing, and the regulatory effects of endodontic materials on the immune response can influence tissue repair. This review aimed to answer whether endodontic sealers can modulate the immune cells and inflammation. An electronic search in Scopus, Web of Science, PubMed, and Google Scholar databases were performed. This systematic review was mainly based on PRISMA guidelines, and the risk of bias was evaluated by SYRCLEs and the Modified CONSORT checklist for in vivo and in vitro studies, respectively. In total, 28 articles: 22 in vitro studies, and six in vivo studies were included in this systematic review. AH Plus and AH 26 can down-regulate iNOS mRNA, while S-PRG sealers can down-regulate p65 of NF-κB pathways to inhibit the production of TNF-α, IL-1, and IL-6. In vitro and in vivo studies suggested that various endodontic sealers exhibited immunomodulatory impact in macrophages polarization and inflammatory cytokine production, which could promote healing, tissue repair, and inhibit inflammation. Since the paradigm change from immune inert biomaterials to bioactive materials, endodontic materials, particularly sealers, are required to have modulatory effects in clinical conditions. New generations of endodontic sealers could hamper detrimental inflammatory responses and maintain periodontal tissue, which represent a breakthrough in biocompatibility and functionality of endodontic biomaterials.

(1) Background: The regenerative procedure has established a new approach to root canal therapy, to preserve the vital pulp of the tooth. This present review aimed to describe and sum up the different approaches to regenerative endodontic treatment conducted in the last 10 years; (2) Methods: A literature search was performed in the PubMed and Cochrane Library electronic databases, supplemented by a manual search. The search strategy included the following terms: "regenerative endodontic protocol", "regenerative endodontic treatment", and "regenerative endodontics" combined with "pulp revascularization". Only studies on humans, published in the last 10 years and written in English were included; (3) Results: Three hundred and eighty-six potentially significant articles were identified. After exclusion of duplicates, and meticulous analysis, 36 case reports were selected; (4) Conclusions: The pulp revascularization procedure may bring a favorable outcome, however, the prognosis of regenerative endodontics (RET) is unpredictable. Permanent immature teeth showed greater potential for positive outcomes after the regenerative procedure. Further controlled clinical studies are required to fully understand the process of the dentin–pulp complex regeneration, and the predictability of the procedure. [ABSTRACT FROM AUTHOR]

Copyright of Otorhinolaryngology (25288253) is the property of Ukrainian Oto-Rhino-Laryngological Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Root canal ecosystem is a complex environment due to its anatomy and persistence of microorganisms; those may reside within the canal after therapeutic efforts and cause subsequent complications and treatment failure. Nanomaterials with unique physicochemical properties have high accessibility to untouched areas of the intracanal ecosystem. Therefore, they have attracted the attention of researchers on the efficacy of nanodentistry in endodontics. This Letter reviews the recent advances in nanodentistry, especially in root canal treatment. In addition, it focuses on the application of nanoparticles in treatment and prevention of a variety of post‐treatment infections in endodontics, treatment of antibiotic resistance and bacterial biofilm structures. In addition, it points out applications of nanoparticles in endodontic materials, restorative materials, dental adhesives, implants, prostheses and dentures. At last, the Letter elaborates on how nanoparticles used for targeted endodontic drug delivery and their efficiently controlled releases. [ABSTRACT FROM AUTHOR]

Copyright of Revista de la Asociación Odontológica Argentina is the property of Asociacion Odontologica Argentina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

(1) Background: The regenerative procedure has established a new approach to root canal therapy, to preserve the vital pulp of the tooth. This present review aimed to describe and sum up the different approaches to regenerative endodontic treatment conducted in the last 10 years; (2) Methods: A literature search was performed in the PubMed and Cochrane Library electronic databases, supplemented by a manual search. The search strategy included the following terms: “regenerative endodontic protocol”, “regenerative endodontic treatment”, and “regenerative endodontics” combined with “pulp revascularization”. Only studies on humans, published in the last 10 years and written in English were included; (3) Results: Three hundred and eighty-six potentially significant articles were identified. After exclusion of duplicates, and meticulous analysis, 36 case reports were selected; (4) Conclusions: The pulp revascularization procedure may bring a favorable outcome, however, the prognosis of regenerative endodontics (RET) is unpredictable. Permanent immature teeth showed greater potential for positive outcomes after the regenerative procedure. Further controlled clinical studies are required to fully understand the process of the dentin–pulp complex regeneration, and the predictability of the procedure.

Resumen La presente comunicación tiene como objetivo informar sobre la cantidad de material que se pierde junto con las puntas dispensadoras descartables durante el uso de materiales endodónticos contenidos en jeringas y comprobar si esa cantidad es significativa en comparación con el contenido total original (15 g). Se procedió a pesar en una balanza de precisión 12 puntas dispensadoras descartables vacías, pertenecientes a dos materiales de uso endodóntico: 2Seal EasyMix (VDW) y Activa BioActive-Base/Liner (PulpDent Corp.). La sumatoria del peso (masa) en las 12 puntas pertenecientes a cada uno de los materiales ensayados fue considerada como peso total de las puntas vacías. Posteriormente, las puntas se llenaron completamente con los materiales, se almacenaron durante 48 horas para permitir el fraguado y finalmente se las pesó nuevamente. La diferencia entre el peso de las 12 puntas vacías y llenas fue considerada como la cantidad de material remanente que se descarta con ellas. La diferencia entre los totales de masa contenida en las puntas llenas de cada material y el contenido original de las jeringas representó la proporción de material que se descarta sin haber sido utilizado. Cuando el porcentaje de material descartado fue menor o igual al 20%, el resultado se consideró aceptable. Se observó que la proporción de ambos materiales fue mayor al 20% (2Seal EasyMix=44,36%; Activa BioActive-Base/Liner=36,87%). Se concluyó que el empleo de materiales endodónticos contenidos en jeringas dispensadoras produce la pérdida de una importante proporción de material durante los procedimientos operatorios. Palabras clave: Jeringas dispensadoras, materiales de obturación, materiales endodónticos, uso ergonómico de materiales dentales. Abstract In order to inform about the amount of material that is lost along with the disposable dispensing tips during the use of endodontic materials contained in deliver syringes and check if that amount is significant compared to the total original content (15 g) of them. 12 empty disposable dispensing tips belonging to two endodontic materials: 2Seal EasyMix (VDW) and ActivaBioactive Base/liner (PulpDent Corp.), were weighed on a precision scale. The sum of the weight (mass) of each of the 12 tips belonging to each of the materials tested was considered as the total weight of the empty tips. Subsequently, the tips were completely filled with the materials, stored for 48 hours to allow them to set and finally weighed again. The difference between the weight of the 12 empty and full tips was considered as the amount of material remaining within them that is discarded. The difference between the total mass contained in 12 filled tips of each material and the original syringe content represented the proportion of material discarded without being used. It was considered that if the % of discarded material was >20% this would be considered acceptable. It was observed that the proportion of both materials was >20% (2Seal EasyMix = 44.36%; ActivaBioactive Base/liner = 36.87%). The use of endodontic materials contained in dispensing syringes causes the loss of a significant proportion of material during the operative procedures. Key words: Delivering syringes, endodontic materials, ergonomic use of dental materials, filling materials.

Introduction: during the process of forensic identification of corpses and burnt, carbonized, or incinerated human remains, the analysis of materials used in dental treatments is a reliable marker for accurate identification. The objective of this study was to describe the radiographic changes of titanium and fiberglass posts cemented in human premolars subjected to high temperatures for forensic purposes. Methods: this was a pseudo-experimental in vitro study to observe the radiographic changes of dental tissues (enamel, dentin, and cement) and the following endodontic materials: gutta-percha (Wave One® by Dentsply Maillefer®), obturation material (Top Seal® by Dentsply Maillefer®), post cementation material (Relyx TM ARC by 3M ESPE®), titanium posts (Tenax® Endodontic Post System by Coltene®), and fiberglass posts (Tenax® Fiber Trans by Coltene®) in 30 human teeth subject to five temperature ranges: 200, 400, 600, 800, and 1000° C. Results: the studied dental tissues and materials are highly resistant to high temperatures without significantly changing their macrostructure (fissures, cracks, fractures, and fragmentation), in such a way that the physical changes can be identified through conventional radiography and associated with each specific temperature range. Conclusions: posts cemented in human premolars have great resistance to the action of high temperatures, so they can be observed through conventional radiography thus contributing to the process of identification and documentation of the medico-legal autopsy of a corpse or human remains that have been burned, incinerated, or carbonized.

Calcium phosphate cements (CPCs) have several advantages for use as endodontic materials, and such advantages include ease of use, biocompatibility, potential hydroxyapatiteforming ability, and bond creation between the dentin and appropriate filling materials. However, unlike tricalcium silicate (CS)-based materials, CPCs do not have antibacterial properties. The present study doped a nonwashable CPC with 0.25-1.0 wt % hinokitiol and added 0, 5, and 10 wt % CS. The CPCs with 0.25-0.5 wt % hinokitiol showed appreciable antimicrobial properties without alterations in their working or setting times, mechanical properties, or cytocompatibility. Addition of CS slightly retarded the apatite formation of CPC and the working and setting time was obviously reduced. Moreover, addition of CS dramatically increased the compressive strength of CPC. Doping CS with 5 wt % ZnO provided additional antibacterial effects to the present CPC system. CS and hinokitiol exerted a synergic antibacterial effect, and the CPC with 0.25 wt % hinokitiol and 10 wt % CS (doped with 5 wt % ZnO) had higher antibacterial properties than that of pure CS. The addition of 10 wt % bismuth subgallate doubled the CPC radiopacity. The results demonstrate that hinokitiol and CS can improve the antibacterial properties of CPCs, and they can thus be considered for endodontic applications. [ABSTRACT FROM AUTHOR]

Introduction The aim of this study was to evaluate the bacterial contamination in endodontic consumables (gutta-percha points, rubber dams, paper mixing pads, caulking agents, and endodontic instrument sponges [EISs]) before and after clinical use and storage. Methods Materials were randomly sampled in triplicates at 3 time points (t 0 , at package opening; t 1 , at 7 days; and t 2 , at 14 days) during their clinical usage. The gutta-percha points and caulking agent (25 mg) were added to 1 mL phosphate-buffered saline (PBS). The rubber dam, paper mixing pad, and EIS were added to 25 mL PBS. After vortexing, centrifuging, and removing the supernatant, the pellet was resuspended in 1 mL PBS, plated on fastidious anaerobic agar, and incubated aerobically and anaerobically. The grown colonies were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). The total bacterial load was calculated in the remaining volume (800 μL) from each sample by quantitative polymerase chain reaction after DNA extraction. Results All tested materials showed a varied number of contaminated samples at the 3 time points (except EIS at t 0 ) using MALDI-TOF MS. The most isolated genera were Propionibacterium (42%) and Staphylococcus (32%). By using non–culture-based approaches, all tested materials at the 3 time points (except gutta-percha at t 0 and the caulking agent at t 0, t 1, and t 2 ) carried bacterial DNA. Conclusions The majority of the tested materials harbored bacteria in their samples before and after clinical storage. Nosocomial infection derived from commonly used consumables could have an impact on the outcome of endodontic treatment. [ABSTRACT FROM AUTHOR]

Introduction. Prognosis of root canal treatment is highly dependent on the quality of endodontic space obturation. The main task of successful root canal treatment is to achieve adequate reparation processes in the apical periodontium. The aim of this study was to evaluate the quality of root canal obturation using the method of gas (argon) penetration through three different endodontic materials. Material and Methods. Thirty recently extracted human single-rooted teeth after root canal instrumentation were divided into three identical groups and obturated with three different endodontic materials: group I - GuttaFlow (RSA, Germany), group II - AH Plus (DeTray, Germany), group III - Acroseal (Septodont, France). The quality of root canal obturation was evaluated using the method of gas permeability. Results. The best results were obtained with GuttaFlow. The average penetration rate of argon was 186.7 seconds. Slightly higher gas porosity had AH Plus, 179.9 seconds, while the highest gas permeability was observed after the application of Acroseal, 178.5 seconds. However, there was no statistically significant difference in gas penetration among these endodontic materials (p>0.05). Conclusion. All three endodontic materials showed gas permeability in a given time interval. The best quality of obturation was achieved with GuttaFlow, while the lowest quality was obtained with Acroseal.

Background: The aim of this study was to investigate in vivo biocompatibility of Resilon, compared with gutta-percha, at short and long-term following implantation in a rat subcutaneous implantation model. Materials and Methods: Male Wistar rats were implanted subcutaneously with either Resilon or gutta-percha or were sham controls. Tissues were harvested at 8 days or 60 days after implantation and were evaluated histologically for inflammation and fibrous encapsulation. The severity of histologic injury, scored on a scale of 0-4 and quantitative analysis of the capsule wall thickness were determined for statistical analysis. Data were analyzed by Student t-test, one-way analysis of variance, Kruskal-Wallis or Mann-Whitney′s tests as appropriate. A value of P ≤ 0.05 was considered statistically significant. Results: No behavioral changes or visible signs of physical impairment were observed at 8 days or 60 days post-implantation. Histopathologic observation of the implanted sites at each time-point showed that both Resilon and gutta-percha implants induced foreign body reaction, showing minimal to mild inflammatory reactions in most cases, which diminished significantly with time. Compared with gutta-percha, the capsule wall was thinner (P > 0.05) after Resilon implantation at day 8 and significantly (P = 0.01) thicker at day 60. In addition, capsule wall thickness showed a trend to increase with time after implantation in the Resilon groups (P > 0.05), opposed to the significant decrease (P = 0.016) observed after implantation in the gutta-percha groups, suggesting lesser long-term biocompatibility of Resilon. Conclusion: Our findings validate Resilon as an in vivo biocompatible material. However, our data suggest that long-term biocompatibility of Resilon, despite validated, is inferior to that of gutta-percha control.

Introduction: The aim of the present study was to investigate and compare the apical sealing ability of Resilon/Epiphany-filled root canals with those that were obturated with gutta-percha/AH-Plus endodontic sealer. Materials and Methods: A total of 60 extracted human single-rooted teeth were selected; 25 teeth for the two test groups and five for each control group. After conducting conventional endodontic treatment, the teeth were immersed in physiologic saline solution for thirty days, and subsequently sealed and stored in methylene blue dye solution for seven days. The teeth were sectioned to evaluate the linear apical leakage using a stereoscopic microscope. The data were statistically analyzed by non-parametric Kruskal-Wallis and Mann-Whitney U tests. Results: The results showed significant differences between the two groups of endodontic sealers (P

Background/aims: Traumatized teeth requiring endodontic intervention may discolor as a result of the treatment performed. Thus, the aim was to investigate the discoloration potential of different endodontic cements, dressings, and irrigants used in dental traumatology.Materials and Methods: Cylindrical cavities were prepared in 330 bovine enamel-dentine blocks (10 × 10 × 3.5 mm), leaving 2 mm of enamel and dentine on the labial side. The specimens were randomly assigned to 22 groups (n = 15). The cavities were filled with a range of endodontic materials, sealed with composite and stored in physiological saline. The color of the labial enamel surface was measured with a spectrophotometer at 7 time intervals: before (T0) and after the placement of the test material (T1 = baseline), after 1 week (T2), 1 month (T3), 3 months (T4), 6 months (T5), and 12 months (T6). The color difference values (ΔE) were calculated and further analyzed by anova and the Tukey-Kramer post hoc test (α = 0.05).Results: After 12 months, significant staining was observed among the endodontic cements only in the Portland cement group with additional bismuth oxide (H-MED PC BiOx; ΔE 22.2). Specimens with other commercially available calcium silicate cements containing bismuth oxide were not significantly discolored. All specimens with endodontic dressings and irrigants were color stable except the tested triple antibiotic paste (M-TreVitaMix; ΔE 14.9) and the double antibiotic paste (N-BiMix; ΔE 14.9). Both mixtures did not contain tetracycline derivatives.Conclusions: The presence of bismuth oxide in calcium silicate cements was not shown to be a reliable predictor for tooth discoloration. Antibiotic pastes without tetracycline derivatives do not guarantee the color stability of teeth. [ABSTRACT FROM AUTHOR]

The dynamic thermomechanical properties, sealing ability, and voids formation of an experimental obturation hydroxyapatite-reinforced polyethylene ( HA/ PE) composite/carrier system were investigated and compared with those of a commercial system [GuttaCore ( GC)]. The HA/ PE system was specifically designed using a melt-extrusion process. The viscoelastic properties of HA/ PE were determined using a dynamic thermomechanical analyser. Human single-rooted teeth were endodontically instrumented and obturated using HA/ PE or GC systems, and then sealing ability was assessed using a fluid filtration system. In addition, micro-computed tomography ( μ CT) was used to quantify apparent voids within the root-canal space. The data were statistically analysed using one-way anova and post hoc tests. The HA/ PE composite exhibited important modulus and damping changes with an increase of temperature. The HA/ PE system was more flexible than GC as the modulus of GC appeared to be significantly higher than that of HA/ PE as a result of the high positive glass transition temperature ( Tg). However, HA/ PE and GC presented similar sealing abilities. In conclusion, because sealing ability and voids formation were comparable between the tested materials, the experimental HA/ PE system may be considered a suitable alternative material for root-canal obturation. Moreover, HA/ PE possesses specific viscoelastic behaviour and lower melting points, which may facilitate root-canal retreatments. [ABSTRACT FROM AUTHOR]

Introduction Silver nanoparticles have been used for different purposes in dentistry, including endodontic treatments. The aim of this study was to determine the cytotoxicity of different types of silver nanoparticles on mouse fibroblast cell line L929 and the reaction of subcutaneous connective tissue of Wistar rats to these nanoparticles. Methods Silver nanoparticles of an average size of 5 nm were synthesized with ammonia (SNA) or polyvinylpyrrolidone (SNP). L929 was exposed to SNA and SNP (0.1–100 μg/mL), and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and enzyme-linked immunosorbent assays were performed after 6, 24, and 48 hours. Culture medium was used as the control. Sixteen rats received, individually, 3 polyethylene tubes filled with a fibrin sponge embedded in 100 μL SNA or SNP (1 μg/mL). A fibrin sponge with no embedding was the control. Tissue reaction was performed qualitatively and quantitatively after 7, 15, 30, and 90 days of implantation in the dorsal connective tissue of Wistar rats. Results SNA and SNP were cytotoxic to L929 in higher concentrations, with SNA significantly more toxic than SNP. SNA and SNP did not induce significant interleukin-1β and interleukin-6 production. The release of stem cell factor by L929 increased 48 hours after the treatment with SNP at 5 μg/mL. Histologic examination showed that the inflammatory responses caused by SNA and SNP at 1 μg/mL were similar to the control in all experimental periods. Conclusions It was concluded that SNA and SNP were not cytotoxic at 25 μg/mL or lower concentrations. However, for safe clinical use, further studies establishing others points of its toxicologic profile are recommended. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the quality of apical obturation of different endodontic materials, using the colored solutions method. As a material, we used 40 single-rooted teeth, extracted from persons of different ages and sex. We did the root-canals preparation using standard endodontical procedure with KERR reamers and files. After we had prepared root canals, we filled them up, using the lentulo-spirals and Gutta-percha points. For the opturation, we used four different endodontic materials aП26, Ketac Endo, Endomethasone and Sealapex. Under the in vitro conditions, we checked the quality of the apical opturation, using the linear dye leakage method and 2 % methylen blue solution. According to results, we can conclude that endodontic materials AH26 (x=1, 37) and Ketac Endo (x=1,17) showed a significantly lower degree of apical leakage than Endomethasone (x=2. 51) and Sealapex (x=3,25).

Background Little is known about which materials and techniques general dentists (GDs) use during endodontic procedures. The objectives were to quantify GDs' use of specific endodontic tools, quantify inappropriate use, and ascertain whether inappropriate use is associated with GDs' practice characteristics. Methods GDs in The National Dental Practice-Based Research Network reported in a questionnaire materials and techniques they use during endodontic procedures. Results Among eligible GDs, 1,490 (87%) participated. Most (93%; n = 1,383) used sodium hypochlorite to irrigate. The most commonly used sealers were zinc oxide eugenol (43%) and resin (40%), followed by calcium hydroxide (26%). Most (62%; n = 920) used a compaction obturation technique; 36% (n = 534) used a carrier-based method. Most (96%; n = 1,423) used gutta-percha as a filler; 5% used paste fillers. Few used irrigants (n = 46), techniques (n = 49), or fillers (n = 10) that investigators classified as inappropriate. Conclusions GDs use a broad range of endodontic techniques and materials, often adapting to newer technologies as they become available. Few GDs use tools that the investigators classified as inappropriate. Practical Implications GDs use many types of endodontic techniques and materials, but only a small percentage of them are inappropriate. [ABSTRACT FROM AUTHOR]

Background: The aim of this experimental study is to assess the bone healing phenomenon produced in the presence of 3 dental materials used for the root canal obturation.Materials and Methods: The biocompatibility of 3 endodontic sealers (a self-curing epoxy resin - AH Plus, a dual cure urethane dimethacrylate resin - RealSeal and a new dual cure endodontic hydroxyapatite based filling material) was investigated after intra-osseous implantation of the materials in rats' calvaria. Tissue reaction was studied at 2, 4, 6, 8, 10 and 12 weeks after implantation using calibrated image retrieval by Olympus. We took into consideration the presence of inflammatory cells (polymorphonuclear leukocytes, macrophages, plasma cells, lymphocytes and giant cells) and classified the aspects of the histological samples according to the following scale: 0 - no inflammation, 1 - mild, isolated inflammation, 2 - moderate, localised inflammatory reaction, 3 - severe, diffuse and intense inflammatory reaction.Results: The inflammatory reaction was present at the 6 intervals for all the tested materials, but a decrease of the inflammatory infiltrate, statistically significant, until extinction for all tested materials was observed at the end of the experimental period. The reaction of bone tissue recovery was most intense in the case of the control area. Lower intensity osteogenesis phenomenon was observed in case of all 3 tested sealers at the end of the experimental period.Conclusions: Biocompatibility and bone healing induction of the new hydroxyapatite based endodontic filling material is comparable to other commercial materials, AH Plus and RealSeal. [ABSTRACT FROM AUTHOR]

Introduction: during the process of forensic identification of corpses and burnt, carbonized, or incinerated human remains, the analysis of materials used in dental treatments is a reliable marker for accurate identification. The objective of this study was to describe the radiographic changes of titanium and fiberglass posts cemented in human premolars subjected to high temperatures for forensic purposes. Methods: this was a pseudo-experimental in vitro study to observe the radiographic changes of dental tissues (enamel, dentin, and cement) and the following endodontic materials: gutta-percha (Wave One® by Dentsply Maillefer®), obturation material (Top Seal® by Dentsply Maillefer®), post cementation material (Relyx TM ARC by 3M ESPE®), titanium posts (Tenax® Endodontic Post System by Coltene®), and fiberglass posts (Tenax® Fiber Trans by Coltene®) in 30 human teeth subject to five temperature ranges: 200, 400, 600, 800, and 1000° C. Results: the studied dental tissues and materials are highly resistant to high temperatures without significantly changing their macrostructure (fissures, cracks, fractures, and fragmentation), in such a way that the physical changes can be identified through conventional radiography and associated with each specific temperature range. Conclusions: posts cemented in human premolars have great resistance to the action of high temperatures, so they can be observed through conventional radiography thus contributing to the process of identification and documentation of the medico-legal autopsy of a corpse or human remains that have been burned, incinerated, or carbonized. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate in vivo biocompatibility of Resilon, compared with gutta-percha, at short and long-term following implantation in a rat subcutaneous implantation model. Materials and Methods: Male Wistar rats were implanted subcutaneously with either Resilon or gutta-percha or were sham controls. Tissues were harvested at 8 days or 60 days after implantation and were evaluated histologically for inflammation and fibrous encapsulation. The severity of histologic injury, scored on a scale of 0-4 and quantitative analysis of the capsule wall thickness were determined for statistical analysis. Data were analyzed by Student t-test, one-way analysis of variance, Kruskal-Wallis or Mann-Whitney's tests as appropriate. A value of P ≤ 0.05 was considered statistically significant. Results: No behavioral changes or visible signs of physical impairment were observed at 8 days or 60 days post-implantation. Histopathologic observation of the implanted sites at each time-point showed that both Resilon and gutta-percha implants induced foreign body reaction, showing minimal to mild inflammatory reactions in most cases, which diminished significantly with time. Compared with gutta-percha, the capsule wall was thinner (P > 0.05) after Resilon implantation at day 8 and significantly (P = 0.01) thicker at day 60. In addition, capsule wall thickness showed a trend to increase with time after implantation in the Resilon groups (P > 0.05), opposed to the significant decrease (P = 0.016) observed after implantation in the gutta-percha groups, suggesting lesser long-term biocompatibility of Resilon. Conclusion: Our findings validate Resilon as an in vivo biocompatible material. However, our data suggest that long-term biocompatibility of Resilon, despite validated, is inferior to that of gutta-percha control. [ABSTRACT FROM AUTHOR]

- It is common knowledge that materials used in endodontics may cause discoloration and thus impair the aesthetic outcome of the treated tooth. The purpose of this review is to summarise the existing knowledge on the discoloration potential of materials used for endodontic procedures. A comprehensive literature search covering the period from 1966 to 2011 was conducted on Pubmed and the Cochrane Library using different keyword combinations including 'tooth', 'colour', 'discoloration', 'staining', 'endodontic''root canal''sealer', 'dressing', 'medicament', 'obturation', 'filling', 'treatment', 'portland cement', 'MTA' and 'antibiotic paste'. Any relevant work published in the English language in peer-reviewed journals and presenting pertinent information related to the purpose of this overview was considered for inclusion. In addition, bibliographies of all relevant papers and previous review articles were hand searched and the reference lists from endodontic textbooks were also reviewed. Articles were excluded if an English abstract was unavailable, if only single clinical reports or conference reports were included, or if the topic was unrelated to the subject. Ten in-vitro studies, one randomized controlled trial and one multicenter randomized controlled trial met the inclusion criteria. There were not any recently used endodontic materials that would not induce at least measurable colour changes. For a wide range of materials currently available on the market there is only scarce or no evidence available on their staining ability. Endodontic therapy should not focus solely on biological and functional aspects, but take aesthetic considerations into account as well. To reduce the risk of material-induced tooth discoloration all materials should be applied carefully in areas of aesthetic concern. The need for further research in this field and for the development of non-staining endodontic materials is evident. [ABSTRACT FROM AUTHOR]

Lenherr P, Allgayer N, Weiger R, Filippi A, Attin T, Krastl G. Tooth discoloration induced by endodontic materials: a laboratory study. International Endodontic Journal, 45, 942-949, 2012. Abstract Aim To investigate the discoloration potential of endodontic materials using a bovine tooth model. Methodology Two hundred and 10 dentine-enamel cuboid blocks (10 × 10 × 3.5 mm) were prepared out of the middle thirds of bovine tooth crowns. Standardized cavities were prepared in the walls of the pulp chamber leaving 2 mm of enamel and dentine on the labial wall of the crown. The specimens were randomly assigned to 14 groups ( n = 15). Endodontic materials were placed into the cavities as follows: group A: empty, group B: blood, group C: calcium hydroxide, group D: ApexCal, group E: Ultracal XS, group F: Ledermix, group G: triple antibiotic paste (3Mix), group H: grey MTA(GMTA), group I: GMTA + blood, group J: white MTA (WMTA), group K: WMTA + blood, group L: Portland cement (PC), group M: PC + blood and group N: AH Plus. The cavities were sealed with composite and stored in water. Standardized colour measurement (VITA Easyshade compact) was performed at the following intervals: prior to (T0) and after placement of the filling (T1), 1 week (T2), 1 month (T3), 3 months (T4), 6 months (T5) and after 1 year (T6). Colour change (ΔE) values were calculated. A two-way analysis of variance was used to assess significant differences between the endodontic materials. The mean values of all groups were compared using the Tukey multiple comparison test (α = 0.05). Results Significant differences were detected amongst the experimental groups after 12 months ( P < 0.0001). The lowest colour change values were observed in the groups N (AH Plus, 3.2 ± 1.5), A (empty, 3.8 ± 1.4), L (PC, 4.1 ± 1.7), C (calcium hydroxide, 4.7 ± 1.5), E (Ultracal XS, 5.1 ± 1.9) and J (WMTA, 7.9 ± 6.7). The most discoloration was measured in groups G (3Mix, 66.2 ± 9.9) and F (Ledermix, 46.2 ± 11.6). PC showed the best colour stability amongst the Portland cement-based materials; however, when contaminated with blood (group M), a significantly higher ΔE value (13.6 ± 4.2) was detected ( P = 0.032). Conclusion Materials used in endodontics may stain teeth. Therefore, the choice of material should not rely solely on biological and functional criteria, but also take aesthetic considerations into account. [ABSTRACT FROM AUTHOR]

Ahmed HMA, Abbott PV. Discolouration potential of endodontic procedures and materials: a review. International Endodontic Journal, 45, 883-897, 2012. Abstract Advances in endodontic materials and techniques are at the forefront of endodontic research. Despite continuous improvements, tooth discolouration, especially in anterior teeth, is considered an undesirable consequence following endodontic treatment as it creates a range of aesthetic problems. This article aims to discuss the intrinsic and internalized tooth discolouration caused by endodontic procedures, and to address the discolouration potential of materials used during root canal treatment, including root canal irrigants, intra-canal medicaments, endodontic and post-endodontic filling materials. In addition, the discolouration patterns caused by combined endodontic and nonendodontic aetiological factors are discussed. The recommended guidelines that should be followed by dental practitioners to prevent and manage tooth discolouration are also outlined. [ABSTRACT FROM AUTHOR]

Background: The success of treatment of a young permanent tooth with pulp necrosis appropriate each stage of development depends primarily on the complete sterilization of infected root canals using specific endodontics drugs capable of destroying pathogenic microorganisms, especially obligate and facultative anaerobic bacteria. Aim: The purpose of this research is to evaluate the antimicrobial effect of the three most used intraradicular substances, respectively mineral trioxide aggregate, calcium hydroxide and calcium hydroxide with iodoform on anaerobic bacteria isolated from infected root canals and also on pure bacterial species, namely Staphylococcus Aureus , Enterococcus Faecalis and Candida Albicans, cultures coming from the collection of the microbiology laboratory. Material and methods: Anaerobic species grown on specific culture medium were prepared in the form of bacterial suspension using standardized system of 0, 5 McFarland turbidity diluted by half. The three drugs tested were used in different concentration and to each of them was added 1 ml of bacterial suspension obtained previously. From each sample obtained were made insemination on specific anaerobic medium and interpretation of results was made by comparing the number of bacterial colonies grown. Results: Following this study MTA has failed to demonstrate superiority over calcium hydroxide in terms of antibacterial properties results showing that each substance tested has elective action on bacterial species. Conclusion: All endodontic materials tested have shown antimicrobial properties able to effectively sterilize infected root canals but they compared different actions on bacterial species taken to study depending on the amount of active substance tested. [ABSTRACT FROM AUTHOR]

Abstract: The bioactivity of a modified Portland cement (wTC) and a phosphate-doped wTC cement (wTC-P) was studied at 37°C in Dulbecco’s Phosphate Buffered Saline (DPBS). The cements, prepared as disks, were analysed at different ageing times (from 1 day to 2 months) by micro-Raman and ATR/FT-IR spectroscopies. The presence of deposits on the surface of the cements and the composition changes as a function of the storage time were investigated. The presence of an apatite deposit on the surface of both cements was already revealed after one day of ageing in DPBS. The trend of the I965/I991 Raman intensity ratio indicated the formation of a meanly thicker apatite deposit on the wTC-P cement at all the investigated times. This result was confirmed by the trend of the I1030/I945 IR intensity ratio calculated until 14 days of ageing. At 2 months, the thickness of the apatite deposit on wTC and wTC-P was about 200 and 500μm, respectively, as estimated by micro-Raman spectroscopy, confirming the higher bioactivity of the phosphate-doped cement. Vibrational techniques allowed to gain more insights into the cement transformation and the different hydration rates of the various cement component. The setting of the cement and the formation of the hydrated silicate gel (C-S-H phase) was spectroscopically monitored through the I830/I945 IR intensity ratio. [Copyright &y& Elsevier]

With the increase in global terrorism there is a higher probability of having to identify victims of incineration events secondary to incendiary explosive devices. The victims of incineration events challenge forensic odontologists when coronal restorations are no longer present to compile postmortem data. With 40 million root canals being completed annually in the United States, a very large pool of antemortem data is available to the forensic odontologist to make positive identifications. When complete and thorough dental records exist, individuals that have undergone surgical and nonsurgical root canal therapy may have materials present in the canal that may aid in identification. This study provides elemental fingerprints of root canal obturation materials to be utilized as a forensic identification aid. This study used scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS) to assess the elemental composition of materials before and after high temperature incineration. Sixteen endodontic materials were analyzed pre-incineration and placed in extracted teeth. The filled teeth were subjected to incineration at 900°C for 30 min to simulate incineration events or cremation. Incinerated materials were radiographed and re-analyzed to determine if they retained their original elemental composition. Endodontic sealers, gutta percha, root-end filling materials, silver points, and separated files were distinguishable in the canal and traceable after incineration. The authors present a fingerprint of the endodontic obturation materials that are capable of withstanding high heat incineration to be used as an aid for postmortem identification. This work represents the initial stage of database generation for root canal filling materials for use as an aid in forensic identification. [ABSTRACT FROM AUTHOR]

Abstract: The biocompatibility of innovative tetrasilicate cements proposed for root-end filling restorations was tested. White ProRoot-MTA and AH Plus were used as control. The new cements were mixed with a local anesthetic solution (4% articaine) to form a paste. Human osteoblast-like cells Saos-2 were challenged in short-term cultures (72 hours) with solid materials and with material extracts prepared in culture medium. Cell growth and viability, cellular attachment, and morphologic features were assessed to verify cell/material interactions. No acute toxicity was exerted by the experimental cements in the assay systems. On solid samples Saos-2 adhered and proliferated on all the experimental cements and on MTA. The ultrastructural findings revealed that Saos-2 were able to adhere and to spread. The maintenance of the osteoblastic phenotype on the innovative cements was confirmed by the alkaline phosphatase assay. All experimental cements prepared with articaine supported the growth of bone-like cells, showing suitable properties to be used as canal sealers and root-end filling materials. [Copyright &y& Elsevier]

Abstract: The purpose of this study was to compare the cytotoxicity, induced apoptosis and/or necrosis, and apoptotic mechanisms in human periodontal ligament (PDL) fibroblasts treated with four different endodontic materials: White ProRoot mineral trioxide aggregate (MTA) (MTA/Dentsply; Tulsa Dental, Memphis, TN), Diaket (ESPE, Seefeld, Germany), Endion (VOCO, Cuxhaven, Germany), and CYMED 8410 (NANO, Kaohsiung, Taiwan). The effects of these four materials on the viability of PDL fibroblasts were determined by MTT (3-(4,5-dimethyl-thiazoyl)-2,5-diphenyl-SH-tetrazolium bromide) assay. Apoptotic pathways were evaluated via several mechanisms. Exposure to MTA for 24, 48, and 72 hours resulted in no significant differences in MTT reduction and viable cell number compared with controls. However, treatment of PDL fibroblasts with Diaket, Endion, and CYMED 8410 for 24, 48, and 72 hours resulted in cytotoxicity with MTT and a reduction of viable cell number with trypan blue dye exclusion test compared with controls (from p < 0.05 to p < 0.001). Annexin V-FITC/PI staining showed that Diaket, Endion, and CYMED 8410 induced higher percentages of apoptosis and/or necrosis than in controls (45.6%, 25.5%, and 6.3%, respectively). Results of cell-cycle analyses were concordant with annexin V-FITC/PI staining findings. These results suggest that MTA is a very biocompatible filling material. However, Diaket, Endion, and CYMED 8410 are toxic to PDL fibroblasts in vitro. The main form of cell death induced by these filling materials was determined to be apoptosis and/or necrosis. [Copyright &y& Elsevier]

Abstract: Delayed setting times may limit the use of mineral trioxide aggregate (MTA) in endodontic procedures. The purpose of this study was to identify types and amounts of MTA additives to enhance its setting properties. Additives tested include saline, 2% lidocaine, 3.0% NaOCl gel, chlorhexidine gluconate gel, K-Y Jelly, 3% and 5% CaCl2. The setting times were evaluated using a Vicat apparatus; compressive strengths of set materials were evaluated with an Instron machine. NaOCl gel, K-Y Jelly and 5% CaCl2 decreased the setting time to 20 to 25 min; compressive strengths of these set materials were significantly lower than MTA mixed with water (p < 0.05). Because MTA mixed with NaOCl gel demonstrated good working properties and improved setting time, this combination may be a viable option in single visit procedures where compressive strength of the material is not a critical issue. [Copyright &y& Elsevier]

Aim To compare the cytotoxicity of materials used to repair perforations using permanent V79 fibroblasts and murine granulocyte-macrophage progenitor cells (CFU-GM). Methodology Set specimens from amalgam, glass–ionomer, SuperEBA, N-Rickert, MTA and gutta-percha were eluted with culture medium for 72 h and their cytotoxicities were assessed by incubating the extracts with V79 and bone marrow-derived progenitors for 24 h and 7 days, respectively. Cytotoxicity on V79 cells was judged using the total nucleic acid content (NAC), neutral red uptake (NRU) and reduction of the tetrazolium salt (MTT). The number of bone marrow CFU-GM colonies determined in clonal cultures stimulated with recombinant murine granulocyte-macrophage colony-stimulating factor was used to assess cytotoxicity to progenitor cells. Statistical analyses were conducted using the one-way analysis of variance and Tukey's test where appropriate. Results All materials were cytotoxic in both cell systems; however, CFU-GM was more sensitive to the extracts than V79 cells. A similar rank order of toxicity was observed in V79 cells using the NAC and the MTT assays: glass–ionomer > N-Rickert ≅ SuperEBA > gutta-percha > amalgam ≅ MTA ( P < 0.05). In contrast, the NRU test exhibited a lower sensitivity to MTA, gutta-percha and amalgam extracts. In the clonal culture assay, the toxicity was less pronounced in the presence of gutta-percha, SuperEBA and MTA. Similar cellular responses were found by placing the set specimens directly in the clonal culture dishes. Conclusions The sensitivity of toxicity depended on the choice of the endpoint and the cell-culture system. Nevertheless, MTA was ranked as the least cytotoxic cement in both cell systems. [ABSTRACT FROM AUTHOR]

Ørstavik D, Qvist V, Stoltze K. A multivariate analysis of the outcome of endodontic treatment. Eur J Oral Sci 2004; 112: 224–230.© Eur J Oral Sci, 2004 In the present study, multivariate analyses were performed on clinical and treatment variables that may influence the outcome of endodontic treatment. Data collected in a previous clinical-radiographic follow-up study were used. Of 810 treated, 675 roots in 498 teeth were followed for 6 months to 4 yr. Of these, 192 (the CAP group) had pre-existing, chronic apical periodontitis and 483 (the NAP group) had not. Root canal treatment followed a standard procedure with one of three sealers chosen at random. Demographic, clinical and radiographic variables were recorded at the start of, and during treatment. The periapical index (PAI) score was used to record the outcome of treatment, and applied in two different endpoint modes (END1 and END2) as the dependent variable for multivariate statistical analyses using logistic regression and the general model. The modes reflected increasing PAI scores (END1) and conventional success/failure assessment (END2). Dropouts were largely similar to the cases followed up. A total of 10 preoperative and peroperative variables were found to be significantly associated with treatment outcome by the multivariate analyses of either the total material or the NAP or CAP subgroups. Several of these were not significant in univariate analyses (e.g. the effect of sealer). Conventional success/failure analyses (END2) identified fewer of the influential variables and had low explanatory power, whereas PAI scores on an ordinal scale (END1) were most sensitive in identifying variables of influence on the treatment outcome. [ABSTRACT FROM AUTHOR]

The cytotoxicity of three resin-based root canal sealers (AH26, AH-plus, Topseal) was evaluated in vitro. The experiments included two cell lines, L929 mouse skin fibroblasts and RPC-C2A rat pulp cells. The cytotoxicity was assessed by sulforodamine B (SRB) colorimetric assay and hemocytometer viable cell counting after 24- and 48-h exposure. AH26 had a severe cytotoxic effect whilst Topseal and AH-Plus showed a markedly lower toxic influence on the cells during the experimental period. [ABSTRACT FROM AUTHOR]

When non-surgical attempts prove unsuccessful or are contraindicated, surgical endodontic therapy is needed to save the tooth. The procedure usually consists of exposure of the involved area. The procedure usually consists of exposure of the involved area, root end resection, root and preparation and insertion of a root end filling material. Numerous materials have been suggested as root end filling materials. This article is a review of the literature on the suitability of various root end filling materials based on their leakage assessment, marginal adaptation, cytotoxicity, and usage test in experimental animals and humans. [ABSTRACT FROM AUTHOR]

We assessed the bond strength of a composite resin to dentin that had been in contact with different materials. Flat dentin surfaces in freshly extracted human teeth were covered for 15 min or 48 h with a 1-mm layer of a variety of materials. The products were mechanically removed and a composite resin cylindrical specimen bonded to the dentin surface using the Prisma universal bond system. After 7 days immersion at 37 degrees C in water, the tensile bond strength was tested. The results were compared with those on dentin surfaces not in contact with any endodontic material. Statistical analysis showed that some materials (Grossmans Cement, IRM, Maisto's slowly resorbable paste) reduced the strength of the bond or even precluded bonding. It is necessary to develop techniques that will eliminate this when restoring endodontically treated teeth. [ABSTRACT FROM AUTHOR]

The long-term effect on periapical healing (8-14 months) of CRCS® and Sealapex® was compared with that of AH 26®. Vital pulpectomy and root canal filling by the hybrid thermomechanical method were performed in teeth of 3 young monkeys. Ten roots with CRCS, 10 with Sealapex and 7 roots with AH 26 were examined after demineralization arid routine histological processing. Hematoxylin and eosin and Brown & Brenn staining for micro-organisms were employed. Mild to severe inflammatory lesions were found at the apical foramina of the roots filled with AH 26 and CRCS. Most of the Sealapex specimens showed no inflammatory cells, except macrophages with sealer particles. A striking finding was a tendency towards apical obliteration with calcificd tissue in roots filled with Seal- apex, apparently following resorption of the sealer. Such a tendency was seldom observed with the other sealers. However, both AH 26 and Sealapex were irritating for a long time when pushed into bone. Despite the interesting results with Sealapex, additional research is needed before its use can he unconditionally recommended. This sealer has not yet been tested in infected cases and its ability to be resorbed, which is an advantage when it. precedes replacement by calcified tissue, may become a disadvantage if it is not followed by apical obliteration. [ABSTRACT FROM AUTHOR]

The clinical performance of three endodontic sealers, AH 26®, Kloroperka N-Ø® and ProcoSol®, was assessed in a prospective study of endodontic treatment in 810 roots. The roots were treated by undergraduate students according to a standardized procedure, and were filled with laterally condensed gutta-percha and sealer. The sealer was randomly selected just prior to filling. The patients were recalled yearly for 4 years for a clinical and radiographic control examination, and the radiographs were scored using the periapical index (PAI) scoring system. Ridit analysis provided optimal discrimination between subgroups of roots with regard to the radiographic status of the periapical tissues as a measure of the clinical performance of the materials. The periapical status of roots filled with AH 26® or ProcoSol® was better than that of roots filled with Kloroperka®. The difference was significant after 1 year and persisted through the 4-year observation period. The difference was also evident after stratification of the material with regard to preoperative pulpal and periapical diagnoses. It is concluded that the choice of sealer may influence the outcome of endodontic treatment, and that the perapical index is a useful discriminatory tool for assessment of treatment results in endodontics. [ABSTRACT FROM AUTHOR]