Effect of calcium hydroxide-based materials on periapical tissue healing and orthodontic root resorption of endodontically treated teeth in dogs

This study evaluated periapical tissue healing and orthodontic root resorption of endodontically treated teeth sealed with calcium hydroxide in dogs. The sample consisted of three contralateral pairs of maxillary incisors and two contralateral pairs of mandibular incisors in each of two dogs using a split mouth design. After biomechanical preparation of the teeth in the first group (n = 10), a Ca(OH)(2) dressing was placed for 14 days before root canal filling with Ca(OH)(2)-based sealer (Sealapex) and gutta-percha points. In the second group (n = 10), root canals were obturated immediately after the mechanical preparation with gutta-percha points and zinc oxide and eugenol (ZOE)-based sealer (Endofill). After completion of endodontic treatment, the teeth were moved with an orthodontic appliance with a calibrated force of 200 g, reactivated every 21 days. After 105 days, the animals were killed and the teeth were removed upon completion of active treatment, without a period of recovery, and prepared for histomorphological analysis. All sections of each tooth were graded subjectively on a scale from one to four to obtain the average of the 16 histomorphological parameters analysed. Evaluation of the differences between the two treatment protocols was made with Mann-Whitney U-test. It was observed that the teeth treated with Ca(OH)(2)-based materials provided better outcomes (P = 5%), with complete repair of all root resorption areas, high rate of biological closure of the main canal and apical accessory canals by newly formed cementum, less intense and extensive chronic inflammatory infiltrate, and better organization of the periodontal ligament. Under the tested conditions, Ca(OH)(2)-based materials had a favourable action on periapical tissue healing and repair of orthodontic root resorption in endodontically treated dogs' teeth.

Rat tissue reaction to MTA FILLAPEX (R)

The aim of this study was to evaluate the rat subcutaneous tissue reaction to implanted polyethylene tubes filled with mineral trioxide aggregate (MTA) FILLAPEX (R) compared to the reaction to tubes filled with Sealapex (R) or Angelus MTA (R). These materials were placed in polyethylene tubes and implanted into the dorsal connective tissue of Wistar rats for 7, 15, 30, 60, and 90 days. The specimens were stained with hematoxylin and eosin or Von Kossa or left unstained for examination under polarized light. Qualitative and quantitative evaluations of the reaction were performed. All materials caused moderate reactions after 7 days, which decreased with time. The reactions were moderate and similar to that evoked by the control and Sealapex (R) on the 15th day. MTA FILLAPEX (R) and Angelus MTA caused mild reactions beginning after 15 days. Mineralization and granulation birefringent to polarized light were observed with all materials. It was concluded that MTA FILLAPEX (R) was biocompatible and stimulated mineralization.

Sealability of MTA and calcium hydroxide-containing sealers

Objectives: The aim of this study was to evaluate the apical sealability of Fillapex (R), Endo-CPM-Sealer (R) and Sealapex (R). Material and Methods: Ninety-four freshly extracted single-rooted teeth were selected and decoronated. All teeth were radiographed to confirm the existence of a single and straight root canal, which was prepared using Protaper Universal and 2.5% sodium hypochlorite. The teeth were randomly divided in groups of 10 specimens each according to the sealer, and the canals were filled using the single cone technique and one of the sealers. Four additional teeth were used as controls. The teeth were submitted to dye leakage with Rhodamine B for 24 h but using vacuum on the initial 15 min. Thereafter, they were cut longitudinally and the leakage was measured in a linear fashion from apex to crown. Data were analyzed by ANOVA and Tukey's tests at 5% significance level. Results: Fillapex (R) and Sealapex (R) showed significantly less dye leakage than Endo-CPM-Sealer (R) (p<0.05). Conclusions: It was concluded that Fillapex (R) and Sealapex (R) were able to prevent apical dye leakage differently from Endo-CPM-Sealer (R).

Reaction of rat connective tissue to a new calcium hydroxide-based sealer

The aim of this study was to histopathologically examine the reaction of the connective tissue of rats to 2 calcium hydroxide-based sealers, Acroseal and Sealapex. Dentin tubes containing the materials and empty control tubes were implanted into the dorsal connective tissue of 36 Wistar albino rats. The animals were killed after 7 or 30 days, and the specimens were prepared for histologic analysis with hematoxylin and eosin, Von Kossa technique, and polarized light. Results were statistically analyzed using Kruskal-Wallis test. Both materials caused mild or moderate inflammatory reactions on the 7th day, but these reactions decreased by the 30th day with no significant difference at any time (P > .05). Mineralization of the subcutaneous tissue of the rats was observed only with Sealapex.

A Mineral Trioxide Aggregate Sealer Stimulated Mineralization

The aim of this study was to evaluate the rat subcutaneous tissue response to implanted polyethylene tubes filled with Endo-CPM-Sealer (Portland Cement Modified Sealer) (EGEO S.R.L., Buenos Aires, Argentina) compared with Sealapex (SybronEndo, Glendora, CA) and Angelus MTA (Angelus, Londrina, Brazil). These materials were placed in polyethylene and dentin tubes and implanted into dorsal connective tissue of Wistar rats for 7, 15, 30, 60, and 90 days. The specimens were prepared to be stained with hematoxylin and eosin or Von Kossa or not stained for polarized light. Qualitative and quantitative evaluations of the reaction were performed. Both materials caused mild to moderate reactions at 7 days that decreased with time. The response was similar to the control on the 30th day with Endo-CPM-Sealer and Angelus MTA and on the 60th day with Sealapex. Mineralization and granulations birefringent to the polarized light were observed with all materials. it was possible to conclude that Endo-CPM-Sealer was biocompatible and stimulated mineralization. (J Endod 2009;35:256-260)

Evaluation of the radiopacity of calcium hydroxide- and glass-ionomer-based root canal sealers

Aim To evaluate the radiopacity of calcium hydroxide-based root canal sealers (Acroseal, Sealapex and Sealer 26), a glass-ionomer-based sealer (Activ GP Sealer) and a zinc oxide and eugenol-based sealer (Intrafill).Methodology Five disc-shaped specimens (10 x 1 mm) were fabricated from each material, according to the International Organization for Standardization (ISO) 6876/2001 standard. After setting of the materials, radiographs were taken using occlusal films and a graduated aluminum step-wedge varying from 2 to 16 mm in thickness. The dental X-ray unit (GE1000) was set at 50 Kvp, 10 mA, 18 pulses s(-1) and distance of 33.5 cm. The radiographs were digitized and the radiopacity compared with that of the aluminum step-wedge, using WIXWIN-2000 software (Gendex). Data (mm Al) were submitted to ANOVA and Tukey test.Results Intrafill was the most radiopaque material (7.67 mm Al) followed by Sealer 26 (6.33 mm Al), Sealapex (6.05 mm Al) and Acroseal (4.03 mm Al). Activ GP was the least radiopaque material (1.95 mm Al, P < 0.05).Conclusions The sealers evaluated in this study had different radiopacities. However, except for the glass-ionomer-based sealer, all materials had radiopacity values above the minimum recommended by the ISO standard.

Comparative assessment of the flow rate of root canal sealers

OBJETIVO: Este estudo avaliou o escoamento do Acroseal, AH Plus, Endomethasone N, Sealapex e ActiV GP de acordo com a especificação ISO 6876/2001. METODOLOGIA: Um volume de 0,05 mL do cimento manipulado de acordo com as recomendações do fabricante foi colocado numa placa de vidro. Aos 180±5 s após o início da espatulação, uma segunda placa de vidro foi colocada sobre o cimento, seguida por um peso de massa de 100 g para fazer um total de 120±2 g. Dez minutos após o começo da manipulação o peso foi removido e o valor do diâmetro do disco de cimento foi mensurado. A média de 3 mensurações para cada cimento foi tomada como o escoamento do material. Os dados foram comparados estatisticamente pelos testes ANOVA e Tukey. RESULTADOS: Os escoamentos obtidos foram: Acroseal 21.,4 mm, AH Plus 22,72 mm, ActiV GP 24,90 mm, Endomethasone N 18,76 mm e Sealapex 25,15 mm. CONCLUSÃO: Apenas o Endomethasone N não se enquadrou na especificação ISO a qual requer que o cimento tenha um diâmetro não inferior a 20 mm. O Sealapex alcançou o melhor escoamento, mas não foi estatisticamente diferente do Activ GP e AH Plus (P>0,05).

Reliability of assessing dye penetration along root canal fillings using methylene blue

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Bacterial leakage in root canals filled with conventional and MTA-based sealers

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Physicochemical properties of endodontic sealers of different bases

Objective: To assess the setting time (ST), flow (FL), radiopacity (RD), solubility (SB) and dimensional change following setting (DC) of different sealers (AH Plus (R), Polifil, Apexit Plus (R), Sealapex (R), Endomethasone (R) and Endofill (R)) according to American National Standards Institute/American Dental Association (ANSI/ADA) Specification 57. Material and methods: Five samples of each material were used for each test. For ST, cast rings were filled with sealers and tested with a Gillmore needle. For FL, the sealer was placed on a glass plate. After 180 s, another plate with 20 g and a load of 100 g were applied on the material, and the diameters of the discs formed were measured. In RD, circular molds were filled with the sealers, radiographed and analyzed using Digora software. For SB, circular molds were filled with the sealers, a nylon thread was placed inside the material and another glass plate was positioned on the set, pressed and stored at 37 degrees C. Samples were weighed, placed in water, dried and reweighed. The water used for SB was analyzed by atomic absorption spectrometry. For DC, circular molds were filled with the sealers, covered by glass plates and stored at 37 degrees C. Samples were measured and stored in water for 30 days. After this period, they were dryed and measured again. Results: Regarding ST, AH Plus (R), Apexit (R) and Endofil (R) sealers are in accordance with ANSI/ADA standards. Endomethasone's manufacturer did not mention the ST; Polifil is an experimental sealer and Sealapex (R) did not set. Considering RD, SB and DC, all sealers were in accordance with ANSI/ADA. The spectrometric analysis showed that a significant amount of K+ and Zn2(+) ions was released from Apexit Plus (R) and Endofill (R), respectively. Conclusion: Except for DC, all other physicochemical properties of the tested sealers conformed to ANSI/ADA requirements.

Clinical microscopic analysis of protaper retreatment system efficacy considering root canal thirds using three endodontic sealers

To evaluate the efficacy of ProTaper Universal rotary retreatment system and the influence of sealer type on the presence of filling debris in the reinstrumented canals viewed in an operative clinical microscope. Forty-five palatal root canals of first molars were filled with gutta-percha and one of the following sealers: G1, EndoFill; G2, AH Plus; G3, Sealapex. The canals were then reinstrumented with ProTaper Universal rotary system. Roots were longitudinally sectioned and examined under an operative clinical microscope (10x), and the amount of filling debris on canal walls was analyzed using the AutoCAD 2004 software. A single operator used a specific software tool to outline the canal area and the filling debris area in each third (cervical, middle, and apical), as well as the total canal area. Data were analyzed by Kruskal-Wallis test and Tukey test at P < 0.05. Sealapex demonstrated significant differences in the average of filling debris area/canal among the 3 thirds. This group revealed that apical third showed more debris than the both cervical and middle third (P < 0.0001). Endofill presented significantly more filling debris than Sealapex in the cervical third (P < 0.05). In the middle (P = 0.12) and apical third (P = 0.10), there were no differences amongst groups. Debris was left in all canal thirds, regardless of the retreatment technique. The greatest differences between techniques and sealers were found in the cervical third. Microsc. Res. Tech. 75:12331236, 2012. (C) 2012 Wiley Periodicals, Inc.

Cimentos endodônticos - selamento marginal apical imediato e após armazenamento de seis meses

Este trabalho avaliou o selamento marginal apical de canais radiculares obturados com os cimentos endodônticos Sealapex, Apexit, Sealer 26 e Ketac Endo. Utilizaram-se 136 raízes, cujos canais radiculares, após o preparo biomecânico, foram obturados pela técnica da condensação lateral ativa com os cimentos em estudo. Metade das amostras, imediatamente após as obturações, foram imersas na solução de azul de metileno a 2% e a outra metade após 6 meses de armazenamento em plasma sangüíneo humano. Observou-se que os cimentos Sealapex e Sealer 26 apresentaram infiltrações médias estatisticamente iguais entre si e menores que as observadas para os demais cimentos (p < 0,05). Amostras imersas no corante imediatamente após a obturação dos canais apresentaram infiltração média menor (0,829 mm) do que aquelas mantidas por 6 meses em plasma sangüíneo humano (1,275 mm). Estas diferenças foram estatisticamente significantes (p < 0,05).

Cimentos endodônticos: análise morfológica imediata e após seis meses utilizando microscopia de força atômica

O objetivo deste trabalho foi analisar a morfologia dos cimentos Sealapex, Apexit, Sealer 26 (cimentos a base de hidróxido de cálcio) e Ketac Endo (cimento de ionômero de vidro), através da microscopia de força atômica, verificando-se as características de suas partículas após a obturação dos canais radiculares e após um período de seis meses de contato com o plasma sanguíneo humano. Utilizaram-se 16 dentes unirradiculares humanos extraídos e incluídos em blocos de resina após o preparo biomecânico. As raízes foram divididas em quatro grupos de quatro raízes cada e os canais radiculares obturados pela técnica de condensação lateral passiva com os cimentos em estudo. Verificou-se que o cimento Apexit foi o que mais sofreu desintegração após seis meses de imersão em plasma sanguíneo humano, seguido pelo Ketac Endo e Sealapex. Dentre todos os cimentos estudados, o Sealer 26 mostrou-se o mais uniforme e com a menor desintegração.

Root canal adhesive filling in dogs' teeth with or without coronal restoration: A histopathological evaluation

The purpose of this study was to evaluate in vivo the response of the periradicular tissues after endodontic treatment and root filling with Epiphany/Resilon (Penntron Clinical Technologies, LLC, Wallingford, CT) or gutta percha and new Sealapex (SybronEndo, Glendora, CA) in dogs' teeth with or without coronal restoration. Teeth without coronal restorations were used to assess the influence of continuous exposure to the oral environment on the periradicular tissues. Sixty root canals with vital pulps in three dogs were instrumented and obturated in a single session and randomly assigned to one of four groups as follows. group 1: root canal filling with Epiphany/Resilon with coronal restoration, group 2: root canal filling with Sealapex sealer and gutta percha with restoration, group 3: root canal filling with Epiphany/Resilon without restoration, and group 4: root canal filling with Sealapex sealer and gutta percha without coronal restoration. After 90 days, the animals were euthanized, and the maxillas and mandibles were removed and submitted for histologic processing. Longitudinal sections were obtained and stained with hematoxylin and eosin, Mallory's trichrome, and Brown and Brenn stains and examined under light microscopy. There were significant differences found between the four groups (p < 0.05). The results showed that roots canals filled with Epiphany/Resilon, with coronal restoration, had significantly less periradicular inflammation than roots canals filled with gutta percha and Sealapex, with coronal restoration (p = 0.021). No significant difference was observed in the intensity of inflammation between roots canals filled with Epiphany/ Resilon with no restoration and roots filled with gutta percha and Sealapex with restoration (p = 0.269). Roots canals filled with gutta percha and Sealapex sealer without coronal restoration showed the greatest degree of periradicular inflammation.

A comparison of one versus two appointment endodontic therapy in dogs' teeth with apical periodontitis

This study was conducted to observe the healing process in dogs' teeth with apical periodontitis after root canal treatment in one or two appointments. Premolars and anterior dogs' teeth had their root canals opened to the oral environment for 6 months before being treated. After root canal negotiation they were filled by the lateral condensation technique with gutta-percha points and Sealapex in one appointment or after a dressing with calcium hydroxide for 7 and 15 days. Six months after the treatment the animals were killed and the tissues prepared for histomorphological analysis. Scores attributed to the different histomorphological events were submitted to statistical analysis, which resulted in ranking the experimental groups from the best to the worst in the following way: (a) calcium hydroxide 14 days; (b) calcium hydroxide 7 days; and (c) one appointment. It was concluded that the use of a calcium hydroxide dressing helps to achieve better results (p < 0.01) than the treatment in one appointment.