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The correct obturation of the root canal system achieved by means of a core and a cement is essential for the success of endodontic treatment. There are several root canal cements (RCCs) on the market; however, because of their excellent characteristics, epoxy resin-based sealers (ERBSs) have been widely used. The main aim of this review was to analyze and integrate the available information on different ERBSs. An electronic search was performed in the PubMed and Scopus databases, using “epoxy resin” AND “root canal treatment”, and “epoxy resin” AND “endodontics” as search terms. In general, ERBSs have good flow properties, film thickness, solubility, dimensional stability, sealing capacity, and radiopacity. They are also able to adhere to dentin while exhibiting low toxicity and some antibacterial effects. However, their main disadvantage is the lack of bioactivity and biomineralization capability. A large number of ERBSs are available on the market, and AH Plus keeps being the gold standard RCC. Yet, information on many of them is limited or non-existent, which could be due to the fact that some of them are relatively new. The latter emphasizes the need for relevant research on the physicochemical and biological properties of some ERBSs, with the aim of supporting their clinical use with sufficient evidence via prospective and long-term studies

Background: This study evaluated the effects of using different root canal sealers and protocols for cleaning intraradicular dentin on the bond strength of a composite resin used to reinforce weakened roots. Material and Methods: Sixty-four roots of extracted human maxillary canines were weakened, prepared and filled with two different endodontic sealers (Endofill and AH Plus). In half of the sample, set aside for each respective sealer, excess filling material was cleaned. In the other half, the weakened areas were not cleaned, and the excess of sealer was spread on the intraradicular dentin. Intentionally worn areas inside each root were restored with a microhybrid light-cure composite resin (Z100) to reinforce them, with and without acid etching. Prefabricated metal posts were fixed with a dual resin cement (RelyX ARC), and the specimens were submitted to a pull-out test. Statistical analysis was performed by means of Shapiro-Wilk, analysis of variance (one-way ANOVA) and Tukey-Kramer tests (p<0.05). Results: The groups filled with Endofill (GI, GII, GIII, GIV) had the lowest bond strength values, which were similar among each other (p>0.05).The greatest bond strength values were observed in roots filled with AH Plus (GV, GVI, GVII, GVIII), mainly without cleaning of the weakened areas, and followed by acid etching (GVII), and also with cleaning of the weakened areas, however, with no acid etching (GVI) (p<0.05). Conclusion: The greatest bond strength values were observed in roots filled with AH Plus; (1) without cleaning of the weakened areas and with acid etching, and; (2) with cleaning of the weakened areas, but without acid etching., Antecedentes: este estudio evaluó los efectos del uso de diferentes selladores de conductos radiculares y protocolos para limpiar la dentina intrarradicular sobre la fuerza de unión de una resina compuesta utilizada para reforzar las raíces debilitadas.Material y Métodos: Sesenta y cuatro raíces de caninos maxilares humanos extraídos fueron debilitadas, preparadas y rellenadas con dos selladores endodónticos diferentes (Endofill y AH Plus). En la mitad de la muestra, reservada para cada sellador respectivo, se limpió el exceso de material de relleno. En la otra mitad, las áreas debilitadas no se limpiaron y el exceso de sellador se esparció sobre la dentina intrarradicular. Las áreas desgastadas intencionalmente dentro de cada raíz se restauraron con una resina compuesta fotopolimerizable microhíbrida (Z100) para reforzarlas, con y sin grabado ácido. Los postes metálicos prefabricados se fijaron con un cemento de resina dual (RelyX ARC) y los especímenes se sometieron a una prueba de extracción. El análisis estadístico se realizó mediante Shapiro-Wilk, análisis de varianza (ANOVA de una vía) y pruebas de Tukey-Kramer (p<0,05).Resultados: Los grupos rellenos con Endofill (GI, GII, GIII, GIV) presentaron los valores más bajos de fuerza de unión, los cuales fueron similares entre sí (p>0,05). Los mayores valores de fuerza de unión se observaron en raíces rellenas con AH Plus (GV , GVI, GVII, GVIII), principalmente sin limpieza de las áreas debilitadas, seguido de grabado ácido (GVII), y también con limpieza de las áreas debilitadas aunque sin grabado ácido (GVI) (p<0.05).Conclusión: Los mayores valores de fuerza de unión se observaron en las raíces rellenas con AH Plus; (1) sin limpieza de las áreas debilitadas y con grabado ácido, y; (2) con limpieza de las áreas debilitadas, pero sin grabado ácido.

Objective: The aim of this study was to assess the micro-push-out bond strength of a mineral-based root canal sealer, BioRoot RCS in canals prepared by K3XF rotary systems of two different tapers. Material and Methods: Eighty caries free maxillary central incisors were used in this study. The samples were allocated into 4 groups (n=20) according to the root canal sealer and taper of the rotary instruments. The samples were obturated using single cone obturation technique. From each root 1mm thick slices at coronal, middle and apical thirds were collected using hard tissue microtome under continuous water coolant. Push-out tests were done for these sections using a Universal testing machine (INSTRON 8801) at a crosshead speed of 1mm/min. One-way analysis of variance (ANOVA) was used to compare the bond strengths within groups and Tukey’s multiple post hoc analysis was used for pair-wise comparison of bond strengths. Results: AH Plus exhibited higher micro-push-out bond strength than BioRootRCS though they did not differ significantly (p>0.05). Preparation of root canals with 6% taper rotary instruments showed higher bond strength than 4% though they did not differ significantly (p>0.05). Conclusion: There was no significant difference between micro-push-out bond strength values of BioRoot RCS and AH Plus. The bond strength values were high in 6% taper canals than 4% canals though the difference was not significant statistically., Objetivo: El objetivo de este estudio fue evaluar la fuerza de unión por micro-expulsión de un sellador de conductos radiculares de base mineral, BioRoot RCS, en conductos preparados por sistemas rotativos K3XF con dos conos diferentes. Material y Métodos: En este estudio se utilizaron 80 incisivos centrales superiores libres de caries. Las muestras se distribuyeron en cuatro grupos (n = 20) de acuerdo al sellador del conducto radicular y al cono de los instrumentos rotativos. Las muestras se obturaron mediante la técnica de obturación de un solo cono. De cada raíz se recogieron rodajas de 1 mm de grosor en los tercios coronal, medio y apical utilizando un micrótomo de tejido duro con refrigeración continua por agua. Posteriormente, se realizó una prueba de expulsión para estas secciones utilizando una máquina de prueba universal (INSTRON 8801) a una velocidad del cabezal transversal de 1mm/min. Se utilizó el análisis de varianza unidireccional (ANOVA) para comparar las resistencias de la unión dentro de los grupos y el análisis post hoc multiple de Tukey se utilizó para la comparación por pares de las resistencias de la unión. Resultados: AH Plus exhibió una fuerza de unión de micro-expulsión más alta que BioRootRCS, aunque no difirieron significativamente (p>0,05). La preparación de los conductos radiculares con instrumentos rotativos ahusados al 6% mostró una fuerza de unión superior al 4%, aunque no difirieron significativamente (p>0,05). Conclusión: No hubo diferencias significativas entre los valores de fuerza de unión de micro-expulsión de BioRoot RCS y AH Plus. Los valores de la fuerza de unión fueron más altos en canales cónicos al 6% que en canales al 4%, aunque la diferencia no fue significativa estadísticamente.

Endodontska terapija predstavlja relativno složenu mikrohiruršku intervenciju na patološki promenjenoj ili traumatsko oštećenoj pulpi. Najčešći uzrok neuspeha endodontske terapije predstavlja apikalno curenje, koje najčešće omogućava progresiju mikroorganizama usled nepotpune kanalne opturacije. Dalji uzroci nespeha su: anatomo-morfološke varijacije kanalnog sistema, kalcifikovani i neprohodni kanali, jako zakrivljeni i zaboravljeni (netretirani) kanali itd. Za kanalnu opturaciju se najčešće koristi gutaperka zbog dobrih fizičkih i bioloških svojstava, ali usled slabe adhezije za dentin i nedovoljnog ispunjavanja mikroprostora unutar kanalnog sistema, uvek se mora koristiti u kombinaciji sa cementom za opturaciju (engl. sealer). Endodontski cementi su odgovorni za popunjavanje nepravilnosti u preparisanim kanalima, eliminisanje preostalih bakterija i hermetičko zaptivanje kanalnog sistema. Idelan endodontski cement ima sposobnost da se lako adaptira za zidove kanala korena zuba, da popuni aksesorne kanale i apikalne ramifikacije, područja resorpcije, nepravilnosti unutar kanalnog sistema, odnosno sve prostore koje gutaperka ne može da ispuni i koji su kao takvi potencijalni rezervoar za bakterijsku kolonizaciju. Endodontski cementi koji poseduju sposobnost penetracije unutar dentinskih tubula mogu ispoljiti potencijalno antibakterijsko svojstvo i time dodatno uticati na broj preostalih bakterija. Cilj ovog istraživanja je bio da se odredi kvalitet zaptivnih svojstava biokeramičkog cementa na bazi kalcijum silikata u odnosu na konvencionalne cemente na bazi epoksi-bisfenol smola i na bazi epoksi-bisfenol smola i kalcijum hidroksida, dve tehnike opturacije kanalnog sistema: monokona tehnika i opturacija tehnikom zagrejane gutaperke na čvrstom nosaču. Materijali i metode: U studiji, uzorak su činili vitalni jednokoreni humani zubi, sa sličnom morfologijom, ekstrahovani iz parodontoloških i ortodontskih razloga. U ispitivanje je uključeno 66 zuba. Uzorak je podeljen u d, Endodontic therapy is a relatively complex microsurgical intervention on a pathologically altered or traumatically damaged pulp. The most common cause of failure of endodontic therapy is apical leakage, which most often allows the progression of microorganisms due to incomplete canal obstruction. Further causes of failure are: anatomo-morphological variations of the canal system, calcified and impassable canals, heavily curved and forgotten (untreated) canals, etc. Gutta-percha is most commonly used for canal obturation because it has a good physical and biological properties, but due to poor dentin adhesion and insufficient filling of the micro space within the canal system, it has to be used in combination with sealer. Endodontic sealers are responsible for filling imperfections in the prepared canals, eliminating the remaining bacteria, and sealing the canal system. Ideal endodontic cement has the ability to adapt to the walls of the root canal, to fill the accessory canals and apical ramifications, areas of resorption, irregularities within the canal system and spaces that the gutta-percha cannot fill, which as such are a potential reservoir for bacterial colonization. Endodontic cements that have the ability to penetrate the dentinal tubules may have exhibit a potential antibacterial capacity and thus further affect the number of bacteria remaining. The aim of this study was to determin the quality of sealing properties of calcium silicate-based bioceramic cement over conventional epoxy-bisphenol resin and epoxy-bisphenol resin and calcium hydroxide cements and two obturation techniques: single-cone technique and Thermafil technique. Materials and methods: In the study, the sample was consisted of vital single-rooted human teeth, with similar morphology, extracted by periodontal and orthodontic reasons. 66 teeth were included in the test. The sample was divided into two groups on the basis of the technique of opturation, and each group was further divided into

Već izvesno vreme u stručnoj literaturi vodi se rasprava o biokompatibilnosti materijala koji se koriste u periapikalnoj hirurgiji. Pored biokompatibilnosti, od materijala za retrogradnu opturaciju kanala korena zuba se očekuje da spreči prodor bakterija iz kanalnog sistema u okolna tkiva. Kvalitetno rubno zaptivanje, odnosno adekvatna marginalna adaptacija su među najznačajnijim faktorima za dugoročan uspeh tretmana. Cilj ovog istraživanja je bio ispitati biokompatibilnost i utvrditi da li postoji razlika u biokompatibilnosti između mineral-trioksid agregata, trikalcijum-silikatnog cementa i amalgama na osnovu tri standadna testa citotoksičnosti, kao i utvrditi marginalnu adaptaciju ispitivanih materijala za retrogradno zatvaranje kanala korena zuba. Materijali i metode: Eksperimentalni deo istraživanja je podeljen na dva dela. U prvom delu istraživanja je vršeno ispitivanje biokompatibilnosti materijala, dok je u drugom delu vršeno ispitivanje marginalne adaptacije na osnovu mikrofotografija dobijenih skening elektronskim mikroskopom. Ispitivanje biokompatibilnosti je izvršeno na dve ćelijske linije, liniji mišjih fibroblasta (L929) i liniji humanih fibroblasta (MRC-5). U eksperimentima su korišćene samo žive (vijabilne) ćelije. Broj ćelija i njihova vijabilnost je određena testom odbacivanja boje sa 0,1% tripan plavim. Vijabilnost ćelija korišćenih u eksperimentu je bila veća od 90%. Biokompatibilnost sve tri vrste materijala je ispitana na osnovu standardnih testova biokompatibilnosti: DET test, MTT test, Agar difuzioni test. Ispitivanje marginalne adaptacije je sprovedeno na 90 ekstrahovanih jednokorenih zuba interkaninog sektora gornje vilice sa intaktnom pulpom, završenim rastom korena, bez frakture i resorpcije korena zuba. Izvršena je endodontska obrada svih zuba i nakon toga su zubi ostavljeni u vlažnoj sredini na 48h, da bi se sprečile frakture prilikom sečenja. Nakon mehaničko medikamentozne obrade i opturacije kanala korena zuba je vršena resekcija vrha, Biocompatibility of materials, deployed in periapical surgery, has been a subject of debate in referential literature for some time now. Apart from biocompabillity, root end filling materials are expected to prevent bacteria from entering the surrounding tissue from canal system. The most important factors for successful long term treatment include marginal seal, i.e. adequate marginal adaptation. The aim of this research was to examine biocompatibility and establish the potential difference in biocompatibility between mineral trioxide aggregate, tricalcium silicate cement and dental amalgam according to three cytotoxicity tests, but also to corroborate marginal adaptation of the materials in question for retrograde seal of a root canal. Materials and methods: The experimental part of the research is divided in two parts. In the first part of the research biocompatibility of the materials was examined, while the examination of the marginal adaptation based on the micro images from scanning electron microscope was conducted in the second part. The examination of biocompatibility was executed on two cell lines, mouse fibroblast cell line (L929) and human cell line (MRC-5).Biocompatibility of all three types of material was examined based on three standard biocompatibility tests: DET test, MTT test, Agar diffusion test.The examination of marginal adaptation was carried out on 90 single-rooted tooth extractied human teeth of the intercanine sector of maxilla with intact pulp, mature apices, without root fractures or resorption. All teeth were endodontically treated. After the extirpation, irrigation and opturation, the resection of 3mm of root apex and retrograde preparation with ultrasonic instruments up to 3 mm depth inside the canal was done. Teeth were divided in three groups alternately. The First group include teeth which apical cavitation was filled with amalgam, in the Second group apical cavitation was filled with MTA, and in the Third group with tricalcium sil

El desarrollo de nuevos cementos de obturación radicular tiene como finalidad conseguir un sellado hermético y obturación tridimensional, siendo fundamental para evitar la microfiltración bacteriana y posibles fracasos del tratamiento endodóntico. Objetivo: Comparar la calidad de sellado de obturación entre dos tipos de cementos: resinoso y biocerámico a 1mm y 4mm del ápice radicular. Materiales y métodos: Se utilizó una muestra de 40 primeros premolares uniradiculares, donados por una clínica particular de la ciudad de Quito- Ecuador. Se dividieron en dos grupos de 20 dientes cada uno, se estandarizó la porción radicular a 16 mm y se conformó endodónticamente con el sistema rotatorio MTwo (VDW), la obturación fue por la técnica de cono único con diferentes cementos siendo: G1: Cemento biocerámico Total Fill BC Sealer (FKG) y G2: Cemento resinoso Top seal (Dentsply). Se seccionó transversalmente las raíces con un micrótomo a 1 y 4 mm del ápice, la calidad del sellado de los cortes se evaluó con Microscopio Electrónico de Barrido (MEB). Los datos se analizaron mediante la prueba estadística ANOVA, con un nivel de significancia de 5%. Resultados: La calidad del sellado del tercio apical radicular a 1 mm del ápice fue de 4,70 ± 1,54 µm y 6,95 ± 2,69 µm para G1 y G2 respectivamente (p=0.003), en la distancia de 4 mm del ápice radicular fue de 8,50 ± 4,54 µm y 9,70 ± 3,24 µm para G1 y G2 respectivamente (p=0.383). Conclusión: La calidad del sellado fue mejor a 1 mm de apical en el cemento biocerámico; sin embargo, a 4 mm no se observó diferencia estadísticamente significativa entre los cementos.

Objective: To systematically review the quality of evidence of available in vitro solubility studies on endodontic sealers according to prespecified evidence criteria. Material and methods: This systematic review was based on the PRISMA guidelines and the AMSTAR measurement tool. A systematic duplicate search of the literature on endodontic sealer solubility studies was conducted in PubMed and Embase databases (until 18 October 2017). Mapping terms to subject headings and free text terms were used and combined with hand searching before exclusion of duplicates. Studies specifically dealing with endodontic sealer solubility were selected. The evidence level was graded (low, medium or high) independently by two investigators following systematic data extraction in pilot forms, which was based on prespecified evidence criteria and the modified CONSORT checklist for in vitro studies on dental materials. Results: The search retrieved 1053 articles, from which 88 were assessed in full. From the 63 articles retained in the final analysis, 11 were classified as having moderate and 52 as low quality of evidence (0 high). The studies graded as low had low sample size (n < 10) and/or insufficient details to allow replicability. Most of the studies did not conform to the modified CONSORT checklist and did not include parameters considered relevant in the prespecified criteria. Conclusions: Existing in vitro studies on the solubility of endodontic sealers do not demonstrate a high quality of evidence. Most of these studies do not present systematic reporting nor employ relevant parameters prespecified in our evidence criteria.

Introduction. So far, the most promising and most commonly used materials in endodontic treatment and retreatment were calcium silicate cements. However, due to the shortage of this material and treatment failures, a new bioactive material was introduced - Biodentinetm. It is a calcium silicate based technology, with excellent handling characteristics and biocompatibility. It can be used in various indications, including dentine substitution and endodontic therapy. Case reports. The clinical cases demonstrated excellent healing potential after the treatment with Biodentinetm. Conclusion . The bio-silicate technology is highly promising, mostly due to its chemical properties and easy clinical manipulation. The short setting time and high mechanical strength makes Biodentinetm a material easy to handle, highly biocompatible, with a wide range of indications., Uvod. Do sada, najčešće korišćeni materijali u endodonciji, i ujedno materijali koji najviše i obećavaju u endodontskom tretmanu­ i retretmanu su bili kalcijum-silikatni cementi. Međutim, u skladu sa nedostacima ovog materijala i neuspesima tretmana, javio se novi materijal Biodentinetm. On je napravljen na kalcijum-silikatnoj tehnologiji sa odličnom biokompatibilnošću kao i karakteristikama u vezi sa aplikacijom materijala. Može da se koristi kod različitih indikacija, uključujući supstituciju dentina i endodontsku terapiju. Prikaz slučajeva. Klinički slučajevi pokazuju odličan potencijal lečenja nakon tretmana­ Biodentinomtm. Zaključak. Biosilikatna tehnologija veoma obećava najviše zbog hemijskih karakteristika i lake kliničke manipulacije. Kratko radno vreme i velika mehanička jačina čini Biodentinetm materijalom koji je jednostavan za korišćenje, visoke biokompatibilnosti i sa velikim opsegom indikacija.

Introduction. The aim of this in vitro study was to test and analyze the sealing ability of three endodontic materials used for permanent obturation, in between the dentin walls and the gutta-percha points, using a scanning electron microscope. Material and Methods. Forty-five recently extracted single-root teeth, treated by a step-back technique, were divided into three groups (15 teeth in each); the canals were filled with three different permanent obturation materials: N2 - zinc oxide root canal cement, Gutta Flow (Coltene), and Endomethasone N (Septodont). Their sealing ability and adhesive properties were analyzed using field emission gun scanning electron microscope, at the time when they were applied between the dentin walls of the canal and the gutta-percha. Results. The results of the scanning electron microscope analysis have shown that all the three sealers have good adhesion properties when used over the root canal walls in the apical third. Good adaptation of the filling used for the root canal walls in the middle and the cervical third was found only in teeth obturated using Gutta Flow, while samples obturated by N2 - zinc oxide root canal cement and Endomethasone showed the weakest adhesion, and greatest number of cracks between the sealer and the canal wall. Conclusion. When using a single-cone obturation technique, compared to other obturation materials, Gutta Flow shows considerably better adaptation to the root canal wall and the gutta-percha points in the apical, middle, and the cervical third of the root., Uvod. Cilj ove in vitro studije je testiranje i analiziranje sposobnosti zaptivanja tri različita endodontska materijala koji se upotrebljavaju za definitivno punjenje između dentinskih zidova i gutaperke poena, primenom elektronskog mikroskopa. Materijal i metode. Četrdeset pet ekstrahovanih jednokorenih zuba, tretiranih step-back tehnikom bili su podeljeni u tri grupe (po 15 zuba u svakoj od njih), kanali su bili ispunjeni trima različitim materijalima za definitivnu opturaciju kanala: cink-oksid eugenolom, Gutta Flow (Coltene) i Endomethasone N (Septodont). Elektronskim mikroiskopom sa emisijom polja analizirani su adhezivna sposobnost i zaptivanje materijala za punjenje između dentinskih zidova korencskog kanala i gutaperke. Rezultati. Analiza elektronski skeniranih mikrofotografija pokazala je da sva tri materijala imaju dobru adheziju karakterističnu za njihovu primenu na zidovima kanala korena u apikalnoj trećini. Dobra adaptacija punjenja za zidove kanala korena u srednje i cervikalne trećine pronađena je samo na uzorke opturisanih metodom Gutta Flow, a uzorci koji su bili opturisani sa cink-oksid eugenolom, i Endomethason-om N imali su najslabiju adheziju i najveće prisustvo pukotina između silera i zida kanala. Kada se primenjuje single-cone tehnika za opturaciju kanala, Gutta Flow pokazuje znatno bolju adaptaciju za zid korenskog kanala i gutaperke u apikalni deo kao i u srednjoj i cervikalnoj trećini korena u poređenju sa drugim materijalima za opturaciju kanala.

Introduction. So far, the most promising and most commonly used materials in endodontic treatment and retreatment were calcium silicate cements. However, due to the shortage of this material and treatment failures, a new bioactive material was introduced - Biodentinetm. It is a calcium silicate based technology, with excellent handling characteristics and biocompatibility. It can be used in various indications, including dentine substitution and endodontic therapy. Case reports. The clinical cases demonstrated excellent healing potential after the treatment with Biodentinetm. Conclusion . The bio-silicate technology is highly promising, mostly due to its chemical properties and easy clinical manipulation. The short setting time and high mechanical strength makes Biodentinetm a material easy to handle, highly biocompatible, with a wide range of indications., Uvod. Do sada, najčešće korišćeni materijali u endodonciji, i ujedno materijali koji najviše i obećavaju u endodontskom tretmanu­ i retretmanu su bili kalcijum-silikatni cementi. Međutim, u skladu sa nedostacima ovog materijala i neuspesima tretmana, javio se novi materijal Biodentinetm. On je napravljen na kalcijum-silikatnoj tehnologiji sa odličnom biokompatibilnošću kao i karakteristikama u vezi sa aplikacijom materijala. Može da se koristi kod različitih indikacija, uključujući supstituciju dentina i endodontsku terapiju. Prikaz slučajeva. Klinički slučajevi pokazuju odličan potencijal lečenja nakon tretmana­ Biodentinomtm. Zaključak. Biosilikatna tehnologija veoma obećava najviše zbog hemijskih karakteristika i lake kliničke manipulacije. Kratko radno vreme i velika mehanička jačina čini Biodentinetm materijalom koji je jednostavan za korišćenje, visoke biokompatibilnosti i sa velikim opsegom indikacija.

Uvod: Sistem kanala korena je složena celina koja pored glavnog korenskog kanala sadrži brojne lateralne, sekundarne, akcesorne kanale, apikalne istmuse i delte, kao i razgranatu mrežu dentinskih tubula. Kako korensko kanalni sistem ne može biti u potpunosti očišćen i dezinfikovan postojećim tehnikama instrumentacije, irigacije i intrakanalne medikacije, uloga kanalnog punjenja se ogleda u postizanju trodimenzionalne opturacije kanalnog prostora, ”pečaćenju” preostalih bakterija i onemogućavanju njihovog prodora u periradikularna tkiva. Ispitivanjem reoloških svojstava mogu se bliže odrediti karakteristike tečenja i viskoelastična svojstva endodontskih materijala. Definisanje i razumevanje reoloških svojstava endodontskih silera u različitim uslovima doprinosi pravilnom rukovanju materijalom shodno primenjenoj tehnici opturacije. Cilj istraživanja: ispitivanje viskoelastičnih svojstava tri različita endodontska silera, uključujući i tečenje / prodor silera u dentinske tubule u kombinaciji sa različitim tehnikama opturacije. Materijal i metode: Ukupan uzorak činilo je 132 meziobukalna i meziolingvalna kanala korena prvih donjih molara. Nakon preparacije kanala krunično-apeksnom tehnikom i ProTaper endodontskim instrumentima, uzorak je podeljen u tri grupe u zavisnosti od ispitivanog silera (AH Plus, Sealapex i EndoREZ) i dodatno u četiri podgrupe shodno primenjenoj tehnici opturacije (hladna lateralna kompakcija, monokona tehnika, opturacija sa čvrstim nosačem gutaperke i topla vertikalna kompakcija), što je činilo ukupno 12 grupa po 11 kanala. Nakon opturacije, uzorci su poprečno presečeni na rastojanju 3, 5 i 8mm od anatomskog foramena, kako bi se dobili preseci koji odgovaraju apikalnoj, srednjoj i koronarnoj trećini kanala. Koronarne površine preseka su analizirane skening elektronskim mikroskopom (SEM). Mesto najdubljeg tubularnog prodora silera je izmereno i izraženo u mikrometrima i procentualno u odnosu na ukupno rastojanje dentinski zid kanala - spoljašnja p, Introduction: The root canal system has a complex anatomy with main root canal and many lateral, secondary, accessory canals, apical isthmuses and deltas, as well as numerous branched dentinal tubules. Due to its complexity, the root canal system cannot be completely cleaned, shaped and disinfected using available techniques of instrumentation, irrigation and intracanal medication. The aim of root canal filling is to achieve a three-dimensional obturation of the root canal space, entomb residual bacteria and prevent their penetration into the periradicular tissue. Defining and understanding the rheological properties of endodontic sealers in different conditions contributes to the proper handling of the material according to the obturation technique applied. The aim: testing the viscoelastic properties of three different endodontic sealers, including the flow / sealer penetration into dentinal tubules in combination with different obturation techniques. Materials and Methods: The total sample consisted of 132 mesiobuccal and mesiolingual root canals of first mandibular molars. After root canal preparation using ProTaper endodontic instruments, in crown-down manner, the sample is divided into three groups depending on the tested sealers (AH Plus, Sealapex and EndoREZ) and additionally into four subgroups according to the obturation technique applied (cold lateral compaction, single-cone technique, carrier – based obturation and warm vertical compaction), making a total of 12 groups of 11 canals. After root canal obturation, the samples were sectioned horizontally at 3, 5 and 8mm from the anatomical foramen, in order to get the sections that correspond to the apical, middle and coronary third of the canal. The coronal surfaces of the sections were analyzed using scanning electron microscopy (SEM). The maximum depth of sealer penetration was measured and expressed in micrometers and as a percent of the total distance: canal dentinal wall - the outer surface of the root

The current report describes the properties of a new apical barrier material formulated from carbonate-containing apatite (CAp) and collagen. CAp particles of around 50 nm were deposited on reconstituted collagen fibers. CAp/col with about 60 wt % CAp (corresponding to apatite content of bone) was obtained after 1 day of calcification. CAp content increased up to about 80 wt % in a 15-day calcification reaction. CAp/col was composed of fine calcified collagen fibers. The crystallinity and Ca/PO(4) ratio of CAp were comparable to those of bone apatite. The mixture of CAp/col and saline reached a pH of about 9. The optimum powder-to-liquid ratio (P/L) to set into a root canal was determined to be 1.2. Furthermore, the mixture (P/L = 1.2) condensed in a root canal was liquid permeable. Thus, the CAp/col was expected as an apical barrier material with osteoconductivity., The current report describes the properties of a new apical barrier material formulated from carbonate-containing apatite (CAp) and collagen. CAp particles of around 50 nm were deposited on reconstituted collagen fibers. CAp/col with about 60 wt % CAp (corresponding to apatite content of bone) was obtained after 1 day of calcification. CAp content increased up to about 80 wt % in a 15-day calcification reaction. CAp/col was composed of fine calcified collagen fibers. The crystallinity and Ca/PO(4) ratio of CAp were comparable to those of bone apatite. The mixture of CAp/col and saline reached a pH of about 9. The optimum powder-to-liquid ratio (P/L) to set into a root canal was determined to be 1.2. Furthermore, the mixture (P/L = 1.2) condensed in a root canal was liquid permeable. Thus, the CAp/col was expected as an apical barrier material with osteoconductivity., source:http://www.sciencedirect.com/science/article/pii/S0099239908005402, source:http://www.journals.elsevier.com/journal-of-endodontics

Introduction. The function of root canal fillings is to seal the root canal system. The important physical property necessary for sealers to achieve this is low solubility. However, any therapeutic effect of calcium hydroxide-based sealers is dependent on the calcium hydroxide being in ionized form, which implies that the material must be at least partly soluble. Objective. The objective of our study was to compare weight changes of Acroseal and Apexit, conventional calcium hydroxide-based sealer and AH Plus, epoxy-amine resin sealer in Hank's solution at different exposure times. Methods. The standardized samples of each material were weighed and immersed in the Hank's solution for 1 h, 24 h, 96 h, 14 days and 28 days. After these exposure times, they were removed, dried, and weighed again. Mean weight changes were determined and the differences between sealers were analysed statistically using a one-way ANOVA. Results. The highest differences in mass were observed in Apexit, 1.52%, and were significantly different from Acroseal, 0.93% (p lt 0.05) and AH Plus, 0.45% (p lt 0.05). There were no significant differences between Acroseal and AH Plus, except for 96 h period. Conclusion. Under the conditions of our study, it may be concluded that the Acroseal sealer presented the behaviour more like epoxy-based material, AH Plus, than calcium hydroxide sealer, Apexit., Uvod. Endodontski sileri se koriste za zaptivanje kanalnog sistema korena zuba. Važna fizička osobina neophodna da se to postigne jeste mala rastvorljivost. Međutim, terapijski efekat silera na bazi kalcijum-hidroksida zavisi od jonizovanosti ovog jedinjenja, što znači da materijal mora biti bar delimično rastvorljiv. Cilj rada. Cilj istraživanja bio je da se uporedi promena mase pasti Acroseal i Apexit, kao konvencionalnih silera na bazi kalcijum-hidroksida, i paste AH Plus, kao silera koji se sastoji od epoksiamin smole, u Henkovom rastvoru pri različitim vremenima izlaganja. Metode rada. Standardizovani uzorci svakog materijala mereni su i potapani u Henkov rastvor na jedan sat, 24 sata, 96 sati, 14 dana i 28 dana. Posle ovih vremenskih intervala uzorci su izvađeni iz rastvora, sušeni i ponovo mereni. Razlike između srednjih vrednosti promene mase silera statistički su analizirane primenom jednosmernog ANOVA testa. Rezultati. Najveća razlika u masi uočena je kod paste Apexit (1,52%), koja je bila statistički značajno veća nego kod pasti Acroseal (0,93%; p lt 0,05) i AH Plus (0,45%; p lt 0,05). Statistički značajne razlike između silera Acroseal i AH Plus nije bilo, izuzev za period od 96 sati. Zaključak. Naše istraživanje je pokazalo da se Acroseal ponaša sličnije sileru baziranom na epoksiamin smoli (AH Plus), nego pasti na bazi kalcijum-hidroksida (Apexit).

Objective: This study tested rat connective tissue response to RealSeal, RealSeal primer or AH Plus after 7, 15, 30, 60 and 90 days of implantation. Material and methods: Thirty Wistar rats had subcutaneous sockets created on their back and received four implants each of polyethylene tubes containing one of the materials tested according to the groups: AH (AH Plus Sealer); RS (RealSeal Sealer); RP (RealSeal Primer); CG (control group – empty tube). After histological processing, sections were analyzed to identify the presence of neutrophils, lymphocytes and plasma cells, eosinophils, macrophages and giant cells, as well as fibrous capsule and abscesses, by an examiner using ligth microscope. Kruskal-Wallis and multiple comparisons test were used for statistical analysis. Significance level was set at 5%.Results: Lymphoplasmacytic infiltrate scores significantly higher than of the control group were observed at 14 and 60 days in AH group, and at 90 days in RS group (p<0.05). There were no differences in terms of presence of macrophages, giant cells, eosinophils, neutrophils and fibrosis. AH Plus group scored higher for abcesses at seven days than any other period (p=0.031)RP group scored higher for lymphoplasmacytic infiltrate at 14 days than at 90 days. Conclusion:The main contribution of this study was to demonstrate that issues involved with tissue tolerance of a Resilon-containing sealer, RealSeal Sealer, cannot be attributed to its primer content.

Objective: This study tested rat connective tissue response to RealSeal, RealSeal primer or AH Plus after 7, 15, 30, 60 and 90 days of implantation. Material and methods: Thirty Wistar rats had subcutaneous sockets created on their back and received four implants each of polyethylene tubes containing one of the materials tested according to the groups: AH (AH Plus Sealer); RS (RealSeal Sealer); RP (RealSeal Primer); CG (control group – empty tube). After histological processing, sections were analyzed to identify the presence of neutrophils, lymphocytes and plasma cells, eosinophils, macrophages and giant cells, as well as fibrous capsule and abscesses, by an examiner using ligth microscope. Kruskal-Wallis and multiple comparisons test were used for statistical analysis. Significance level was set at 5%.Results: Lymphoplasmacytic infiltrate scores significantly higher than of the control group were observed at 14 and 60 days in AH group, and at 90 days in RS group (p<0.05). There were no differences in terms of presence of macrophages, giant cells, eosinophils, neutrophils and fibrosis. AH Plus group scored higher for abcesses at seven days than any other period (p=0.031)RP group scored higher for lymphoplasmacytic infiltrate at 14 days than at 90 days. Conclusion:The main contribution of this study was to demonstrate that issues involved with tissue tolerance of a Resilon-containing sealer, RealSeal Sealer, cannot be attributed to its primer content.

Introduction. The function of root canal fillings is to seal the root canal system. The important physical property necessary for sealers to achieve this is low solubility. However, any therapeutic effect of calcium hydroxide-based sealers is dependent on the calcium hydroxide being in ionized form, which implies that the material must be at least partly soluble. Objective. The objective of our study was to compare weight changes of Acroseal and Apexit, conventional calcium hydroxide-based sealer and AH Plus, epoxy-amine resin sealer in Hank's solution at different exposure times. Methods. The standardized samples of each material were weighed and immersed in the Hank's solution for 1 h, 24 h, 96 h, 14 days and 28 days. After these exposure times, they were removed, dried, and weighed again. Mean weight changes were determined and the differences between sealers were analysed statistically using a one-way ANOVA. Results. The highest differences in mass were observed in Apexit, 1.52%, and were significantly different from Acroseal, 0.93% (p lt 0.05) and AH Plus, 0.45% (p lt 0.05). There were no significant differences between Acroseal and AH Plus, except for 96 h period. Conclusion. Under the conditions of our study, it may be concluded that the Acroseal sealer presented the behaviour more like epoxy-based material, AH Plus, than calcium hydroxide sealer, Apexit., Uvod. Endodontski sileri se koriste za zaptivanje kanalnog sistema korena zuba. Važna fizička osobina neophodna da se to postigne jeste mala rastvorljivost. Međutim, terapijski efekat silera na bazi kalcijum-hidroksida zavisi od jonizovanosti ovog jedinjenja, što znači da materijal mora biti bar delimično rastvorljiv. Cilj rada. Cilj istraživanja bio je da se uporedi promena mase pasti Acroseal i Apexit, kao konvencionalnih silera na bazi kalcijum-hidroksida, i paste AH Plus, kao silera koji se sastoji od epoksiamin smole, u Henkovom rastvoru pri različitim vremenima izlaganja. Metode rada. Standardizovani uzorci svakog materijala mereni su i potapani u Henkov rastvor na jedan sat, 24 sata, 96 sati, 14 dana i 28 dana. Posle ovih vremenskih intervala uzorci su izvađeni iz rastvora, sušeni i ponovo mereni. Razlike između srednjih vrednosti promene mase silera statistički su analizirane primenom jednosmernog ANOVA testa. Rezultati. Najveća razlika u masi uočena je kod paste Apexit (1,52%), koja je bila statistički značajno veća nego kod pasti Acroseal (0,93%; p lt 0,05) i AH Plus (0,45%; p lt 0,05). Statistički značajne razlike između silera Acroseal i AH Plus nije bilo, izuzev za period od 96 sati. Zaključak. Naše istraživanje je pokazalo da se Acroseal ponaša sličnije sileru baziranom na epoksiamin smoli (AH Plus), nego pasti na bazi kalcijum-hidroksida (Apexit).

Objective: This study tested rat connective tissue response to RealSeal, RealSeal primer or AH Plus after 7, 15, 30, 60 and 90 days of implantation. Material and methods: Thirty Wistar rats had subcutaneous sockets created on their back and received four implants each of polyethylene tubes containing one of the materials tested according to the groups: AH (AH Plus Sealer); RS (RealSeal Sealer); RP (RealSeal Primer); CG (control group – empty tube). After histological processing, sections were analyzed to identify the presence of neutrophils, lymphocytes and plasma cells, eosinophils, macrophages and giant cells, as well as fibrous capsule and abscesses, by an examiner using ligth microscope. Kruskal-Wallis and multiple comparisons test were used for statistical analysis. Significance level was set at 5%.Results: Lymphoplasmacytic infiltrate scores significantly higher than of the control group were observed at 14 and 60 days in AH group, and at 90 days in RS group (p<0.05). There were no differences in terms of presence of macrophages, giant cells, eosinophils, neutrophils and fibrosis. AH Plus group scored higher for abcesses at seven days than any other period (p=0.031)RP group scored higher for lymphoplasmacytic infiltrate at 14 days than at 90 days. Conclusion:The main contribution of this study was to demonstrate that issues involved with tissue tolerance of a Resilon-containing sealer, RealSeal Sealer, cannot be attributed to its primer content.

This clinical study prospectively evaluated the influence of various predictors on healing outcome 1 year after periapical surgery. The study cohort included 194 teeth in an equal number of patients. Three teeth were lost for the follow-up (1.5% drop-out rate). Clinical and radiographic measures were used to determine the healing outcome. For statistical analysis, results were dichotomized (healed versus nonhealed). The overall success rate was 83.8% (healed cases). The only individual predictors to prove significant for the outcome were pain at initial examination (p=0.030) and other clinical signs or symptoms at initial examination (p=0.042), meaning that such teeth had lower healing rates 1 year after periapical surgery compared with teeth without such signs or symptoms. Logistic regression revealed that pain at initial examination (odds ratio=2.59, confidence interval=1.2-5.6, p=0.04) was the only predictor reaching significance. Several predictors almost reached statistical significance: lesion size (p=0.06), retrofilling material (p=0.06), and postoperative healing course (p=0.06).

This clinical study prospectively evaluated the influence of various predictors on healing outcome 1 year after periapical surgery. The study cohort included 194 teeth in an equal number of patients. Three teeth were lost for the follow-up (1.5% drop-out rate). Clinical and radiographic measures were used to determine the healing outcome. For statistical analysis, results were dichotomized (healed versus nonhealed). The overall success rate was 83.8% (healed cases). The only individual predictors to prove significant for the outcome were pain at initial examination (p=0.030) and other clinical signs or symptoms at initial examination (p=0.042), meaning that such teeth had lower healing rates 1 year after periapical surgery compared with teeth without such signs or symptoms. Logistic regression revealed that pain at initial examination (odds ratio=2.59, confidence interval=1.2-5.6, p=0.04) was the only predictor reaching significance. Several predictors almost reached statistical significance: lesion size (p=0.06), retrofilling material (p=0.06), and postoperative healing course (p=0.06).

Rather easy to perform, pulpotomy of the deciduous teeth is the most frequent endodontic treatment performed on children, but also the most controversial. Based on the amputation of the pulp chamber and the conservation of the inflammation-free root canals, the clinical results can be good, depending on the materials used. In this, calcium hydroxide (Ca(OH)2) as well as zinc-oxide-eugenol (ZOE) have been proven very inflammatory whereas Formocresol (FC) remains the reference even if its clinical toxicity is still reported in literature on a very controversial way. Nevertheless, this was sufficient to trigger and stimulate a search for alternatives, and led to the proposition to use ferric sulfate and even more recently MTA as new bases for the treatment of the pulp stumps after pulp chamber amputation.

On non-vital deciduous molars, inter-radicular bone resorption is often an indication of extraction. The endodontic treatment of these teeth by means of zinc oxide-eugenol (ZOE) paste also showed its limits. To mitigate the deficiencies of this material, we suggested a preliminary treatment by means of calcium hydroxide (Ca(OH)2) for its anti-inflammatory and antiseptic properties as well as its ability to stimulate calcified tissues apposition or remineralisation. This study concerns 21 non-vital deciduous molars. X-rays excluded any lesion of the underlying permanent bony crypt (bone tissue) as well as any inflammation of the dental follicle. After preparation, root canals were filled by means of Pulpdent. An initial X-ray check was made 15 days and then every 3 months. After disappearance of the inflammatory resorption, root canal fillings were performed with ZOE paste. The remineralisation of the inter-radicular alveolar bone was observed for 14 deciduous molars, which were then filled using ZOE. The remineralisation period varies from 3 to 18 months depending on the scale of the lesion. Of the 7 failed treatments, 3 failed following downfall of the crown filling material, and 2 due to failure to keep appointments and late replacement of resorbed Ca(OH)2. On 2 teeth, the treatment did not stop the lesion forming. Calcium hydroxide (Ca(OH)2) give encouraging results in the treatment of inter-radicular alveolar bone resorption of non-vital deciduous tooth. Its fast resorption requires rigorous controls, frequent refills, and thus strong motivation on the part of the child and parents. It cannot, on any account, be considered as permanent filling material.

Cytotoxicity testing, as a standard assay for toxicity of dental materials, is useful for initial biocompatibility evaluations. In vitro test of calcium hydroxyapatite (CHA) with established laboratory cell line showed multiple partitions of cells proving good biocompatibility properties of this new material. Further research should be directed towards simulation of in vivo conditions and animal experimentation to obtain sufficient data before its clinical application in humans.

Cytotoxicity testing, as a standard assay for toxicity of dental materials, is useful for initial biocompatibility evaluations. In vitro test of calcium hydroxyapatite (CHA) with established laboratory cell line showed multiple partitions of cells proving good biocompatibility properties of this new material. Further research should be directed towards simulation of in vivo conditions and animal experimentation to obtain sufficient data before its clinical application in humans.

Cytotoxicity testing, as a standard assay for toxicity of dental materials, is useful for initial biocompatibility evaluations. In vitro test of calcium hydroxyapatite (CHA) with established laboratory cell line showed multiple partitions of cells proving good biocompatibility properties of this new material. Further research should be directed towards simulation of in vivo conditions and animal experimentation to obtain sufficient data before its clinical application in humans.

OBJECTIVE: To compare the clinical and radiographic treatment outcome of retrograde root filling with either dentin-bonded resin composite (Retroplast, RP) or glass ionomer cement (Chelon-Silver, CS).STUDY DESIGN: A prospective, randomized clinical study of 134 consecutive patients with indication of retrograde root filling of an incisor, canine, premolar, or first molar. Either RP or CS was chosen at random as retrograde filling material. Either material was applied onto the entire resection surface after prepared slightly concave. This preparation technique makes a sealing of the entire resection surface possible and prevents marginal contraction gaps during polymerization. A total of 122 patients were available for 1-year follow-up.RESULTS: After 1 year the proportion of successful cases was significantly higher in the RP group (73%) than in the CS group (31%) (p<0.001). Doubtful healing with a need for a longer observation period was seen in 17% of the RP cases and 19% of the CS cases. The proportion of failures in the RP group (10%) was significantly lower than that in the CS group (50%) (p<0.001). Most of the unsuccessful CS cases failed due to loosening of the retrograde filling.CONCLUSIONS: Dentin-bonded RP applied onto the entire, slightly concave resection surface is a predictable apical sealant characterized by a high success rate. In contrast, retrograde root filling with CS results in an unacceptably high failure rate due to insufficient bonding strength to the concave resection surface.

OBJECTIVE: To compare the clinical and radiographic treatment outcome of retrograde root filling with either dentin-bonded resin composite (Retroplast, RP) or glass ionomer cement (Chelon-Silver, CS).STUDY DESIGN: A prospective, randomized clinical study of 134 consecutive patients with indication of retrograde root filling of an incisor, canine, premolar, or first molar. Either RP or CS was chosen at random as retrograde filling material. Either material was applied onto the entire resection surface after prepared slightly concave. This preparation technique makes a sealing of the entire resection surface possible and prevents marginal contraction gaps during polymerization. A total of 122 patients were available for 1-year follow-up.RESULTS: After 1 year the proportion of successful cases was significantly higher in the RP group (73%) than in the CS group (31%) (p<0.001). Doubtful healing with a need for a longer observation period was seen in 17% of the RP cases and 19% of the CS cases. The proportion of failures in the RP group (10%) was significantly lower than that in the CS group (50%) (p<0.001). Most of the unsuccessful CS cases failed due to loosening of the retrograde filling.CONCLUSIONS: Dentin-bonded RP applied onto the entire, slightly concave resection surface is a predictable apical sealant characterized by a high success rate. In contrast, retrograde root filling with CS results in an unacceptably high failure rate due to insufficient bonding strength to the concave resection surface.