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Aims: This study aims to comparatively assess the impact of root canal irrigants on the push-out bond strength (POBS) of mineral trioxide aggregate (MTA), biodentine, and EndoSequence root repair material (ERRM). Materials and Methods: In this in vitro study, the midroot dentin of human canine teeth was sectioned horizontally into slices of 1.5 mm thick. The canal lumen of each dentin slice was then enlarged to a diameter of 1.3 mm using a No. 5 GG drill. One hundred and twenty samples were then randomly split into three groups (n = 40), and the following materials were filled into the canal space, respectively: ProRoot MTA, biodentine, and ERRM putty. The samples were covered with damp gauze for 10 min. They were subsequently divided into four subgroups (n = 10) to be immersed in 3% sodium hypochlorite, saline, 2% chlorhexidine gluconate, and no irrigant (control), respectively. After incubation for 48 h, the POBS of the samples was determined using a universal testing machine. A stereomicroscopic examination of the samples was done to ascertain the nature of the bond failures. One-way ANOVA was employed to assess the differences in POBS among the three materials when exposed to different irrigants and pairwise comparison was done using post hoc Tukey test. The significance level was set to P < 0.05. Results: ERRM demonstrated the highest POBS of 6.83 ± 0.94 MPa when tested with normal saline and ProRoot MTA recorded the lowest POBS of 3.44 ± 0.47 MPa under chlorhexidine. Under saline, both ERRM and biodentine showed a significantly better (P < 0.05) POBS value than ProRoot MTA. With NaOCl, ERRM showed a significantly better (P < 0.05) POBS value than ProRoot MTA and biodentine. With chlorhexidine, both ERRM and biodentine showed significantly better results (P < 0.05) as compared to ProRoot MTA. Conclusions: ERRM showed the highest POBS value irrespective of the irrigant used, whereas ProRoot MTA showed the least. This suggests that ERRM may be the preferred choice for root repair, especially when using chlorhexidine as an irrigant. [ABSTRACT FROM AUTHOR]

Background: Root repair material ideal characteristics are its ability to adapt to the walls of root canal and avoid leakage of microorganisms and their by‑products into the peri‑radicular tissue. They should be biocompatible, able to produce osteogenesis and cementogenesis, bacteriostatic, radiopaque, and remain unaffected by blood and moisture. Tissue inflammation and metabolic acidosis following bacterial colonization in pathological condition such as necrotic pulp or periapical abscess lead to change in neutral pH. The pH near periapical tissue lowers to around 5.5. The purpose of this research is to determine the effect of acidic media such as butyric acid on bond strength on mineral trioxide aggregate (MTA), Biodentine (BD), and EndoSequence root repair materials (ERRM) with root dentin wall. Methodology: The research was conducted in Vasantdada Patil Dental College. About 60 extracted teeth without any curve canal were selected. They were further divided into three groups of 20 each. Using diamond saw disc, mid root dentin were sectioned horizontally to thickness of 2.0–2.1 mm, further root repair materials were mixed according to instruction given by manufacturer. Result: The result concluded that push‑out bond strength in both phosphate‑buffered saline and acidic environment was higher with ERRM. Conclusion: Thickening agent and fillers added in ERRM result in higher push bond strength than MTA and BD. [ABSTRACT FROM AUTHOR]

Objectives: To assess the cytocompatibility and bioactive potential of the new calcium silicate-based cement Ceraputty on human periodontal ligament stem cells (hPDLSCs) compared to Biodentine and Endosequence BC root repair material (ERRM). Materials and methods: hPDLSCs were isolated from extracted third molars from healthy donors. Standardized sample discs and 1:1, 1:2, and 1:4 eluates of the tested materials were prepared. The following assays were performed: surface element distribution via SEM–EDX, cell attachment and morphology via SEM, cell viability via a MTT assay, osteo/cemento/odontogenic marker expression via RT-qPCR, and cell calcified nodule formation via Alizarin Red S staining. hPDLSCs cultured in unconditioned or osteogenic media were used as negative and positive control groups, respectively. Statistical analysis was performed using one-way ANOVA or two-way ANOVA and Tukey's post hoc test. Statistical significance was established at p < 0.05. Results: The highest Ca2+ peak was detected from Biodentine samples, followed by ERRM and Ceraputty. hPDLSC viability was significantly reduced in Ceraputty samples (p < 0.001), while 1:2 and 1:4 Biodentine and ERRM samples similar results to that of the negative control (p > 0.05). Biodentine and ERRM exhibited an upregulation of at least one cemento/odonto/osteogenic marker compared to the negative and positive control groups. Cells cultured with Biodentine produced a significantly higher calcified nodule formation than ERRM and Ceraputty (p < 0.001), which were also higher than the control groups (p < 0.001). Conclusion: Ceraputty evidenced a reduced cytocompatibility towards hPDLSCs on its lowest dilutions compared to the other tested cements and the control group. Biodentine and ERRM promoted a significantly higher mineralization and osteo/cementogenic marker expression on hPDLSCs compared with Ceraputty. Further studies are necessary to verify the biological properties of this new material and its adequacy as a retrograde filling material. Clinical relevance: This is the first study to elucidate the adequate biological properties of Ceraputty for its use as a retrograde filling material. [ABSTRACT FROM AUTHOR]

The study aims to investigate the quality of dentin barriers and pulp reaction to EndoSequence Root Repair Material (ERRM) combined with low‐level laser application. In eight dogs, pulps were exposed via class V, half of the samples received low‐level diode laser at 870 nm. Thereafter, cavities were capped with fast‐set or regular‐set ERRM. The specimens were processed for histomorphological and immunohistochemical examination after 2 weeks and 2 months. Dentin bridges were observed in all samples, and 87.5% were complete. The low‐level laser group had significantly more reparative dentin area than the non‐lased group (p < 0.05). The dentin bridges were found to have an unprecedented tubularity of 43%–89%. Tiny dentin island formation was observed within the material particles. Initial mild‐to‐moderate inflammatory reactions were observed, which subsided after 2 months. RUNX2 and osteocalcin staining were evident for all samples at both time intervals. Low‐level laser combined with bioactive ERRM is effective in inducing reparative dentin formation. [ABSTRACT FROM AUTHOR]

Abstract Background The study aims to investigate the pulp and periapical reaction and healing after capping with EndoSequence Root Repair Material (ERRM) combined with low-level laser application. Methods In 6 rabbits, pulps were exposed via class V, half of the samples received a low-level diode laser at 980 nm. Thereafter, cavities were capped with regular-set ERRM. The specimens were processed for histomorphological examination after 2 weeks and two months. Results After 2 weeks, images show mild inflammation and organized odontoblasts in lased group. The non-lased group shows more severe inflammation. The predentin thickness was thicker in the lased group with statistical significance (p

Objective: Present in-vitro study aimed to evaluate the apical leakage of different bioceramic retrofilling materials with and without smear layer. Materials and Methods: Sixty human single-rooted teeth were decoronated at a standardized root length of 13 mm, chemo-mechanically prepared and obturated. After obturation, root-end resection was done and root-end cavities were prepared using ultrasonic tips. The specimens with prepared retro cavities were randomly assigned into 2 groups (n = 30) based on the smear layer removal protocol used. Each group was further subdivided into 3 subgroups (n = 10) based on the bioceramic retrofilling material MTA (Mineral Trioxide Aggregate; Proroot Dentsply/Tulsa), CEM (Calcium-Enriched Mixture; Bionique Dent, Tehran) and ERRM (EndoSequence® Root Repair Material; Brasseler USA, Savannah, GA). The extension of dye (2% Rhodamine B) penetration was measured in millimetre using a stereomicroscope at 10× zoom. Results were statistically analysed using one-way ANOVA (analysis of variance) test and unpaired Student's t test. Results: In the presence of smear layer, MTA demonstrated maximum mean apical leakage value (1.70 ± 0.30), followed by CEM (1.40 ± 0.37) and ERRM (1.40 ± 0.23), which was statistically not significant. Without the smear layer, ERRM demonstrated the least mean apical leakage value, which was statistically significant as compared with CEM (P

Background: The study aims to investigate the pulp and periapical reaction and healing after capping with EndoSequence Root Repair Material (ERRM) combined with low-level laser application. Methods: In 6 rabbits, pulps were exposed via class V, half of the samples received a low-level diode laser at 980 nm. Thereafter, cavities were capped with regular-set ERRM. The specimens were processed for histomorphological examination after 2 weeks and two months. Results: After 2 weeks, images show mild inflammation and organized odontoblasts in lased group. The non-lased group shows more severe inflammation. The predentin thickness was thicker in the lased group with statistical significance (p < 0.05). After 2 months, inflammatory cells were sparse in both lased and non-lased groups. In the periapical area, group one showed dilated blood vessels and thick fibrous connective tissues. In group two, there were more numerous maturations of PDL fibers with scattered inflammatory cells and congested blood vessel. Conclusions: Using low-level laser therapy in combination with ERRM for pulp capping shortens the inflammatory phase and enhances healing. [ABSTRACT FROM AUTHOR]

The study aimed to assess the human pulpal response to direct pulp capping using Endosequence Root Repair Material (ERRM) and Endocem MTA against ProRoot MTA as control. Intentional direct pulp capping was done using the three materials in 30 caries‐free human premolars. After 30 days, the teeth were extracted, fixed and decalcified. Sections were prepared for histologic examination using light microscopy. Thickness and quality of dentine bridge formed and level of inflammation were evaluated. Difference between dentine bridge thickness of the three groups was statistically significant. Mean thickness of dentine bridges formed in ProRoot MTA group was greater than other two groups, and difference was statistically significant. Difference in dentine bridge thickness between ERRM and Endocem MTA was statistically significant. No significant difference was observed between the 3 groups with respect to inflammation. Results indicate ProRoot MTA performed best with ERRM giving better results than Endocem MTA. [ABSTRACT FROM AUTHOR]

Background: Perforations can occur during any endodontic procedure which may affect prognosis if not repaired immediately. During perforation repair, various irrigating solutions were used which may affect the bond strength of repair materials. Methods: In this study, sixty dentin slices of 2 mm thickness were prepared with lumen 1.3 mm. Samples were divided into two groups. Biodentine and EndoSequence Root Repair Material (RRM) were placed in the respective samples and incubated for 24 h. Subdivision of groups into three was done: control, 17% ethylenediaminetetraacetic acid (EDTA), and QMix. Immersion was done for 30 min, followed by incubation for 48 h. The samples were then tested for compressive strength through a push-out test. The mean, standard deviation, median, and range of bond strength of EndoSequence Bioceramic RRM and Biodentine were obtained. One-way analysis of variance was used to determine the statistical significance of difference in the mean push-out strengths of each material across decalcifying agents. Paired analysis of push-out strength between decalcifying agents for each material was performed using Tukey's post hoc test. All the analyses were performed using R-3.0.0 programming language, and the statistical confidence was tested at 95%. Results: Results showed that EndoSequence RRM had superior bond strength than Biodentine. 17% EDTA and QMix showed negative influence on the bond strength. However, QMix samples had more bond strength than 17% EDTA. Conclusion: QMix showed less negative influence than EDTA on Biodentine and EndoSequence RRM.

Background:To compare the color stabilities of wMTA Angelus, Biodentine, EndoSequence Root Repair Material, and BIO MTA+. Calcium silicate-based materials in response to the exposure to different irrigation solutions. Methods:Four groups of materials (4 samples in each) were involved in the present study. Each of materials was homogenously mixed and placed in each container.After the setting time, all of the samples colors before the contact with solutions were determined by using a spectrophotometer. Then one sample from each material was kept in each of 4 irrigation solutions for 24 hours: distilled water, 5.25% NaOCl, 2% chlorhexidine gluconate (CHX] and 17% ethylenediaminetetraacetic acid (EDTA]. At the end of this period, the samples were taken out of the solutions and the color measurements were repeated. Results:Among all the materials, the discoloration of distilled water group was found to be the lowest at statistically significant level. The discoloration when exposed to Biodentine and wMTA Angelus irrigation solutions was at clinically acceptable level when compared to ES and BIO MTA+. Conclusions:Biodentine and wMTA Angelus may be used by clinicians as an alternative when the esthetic concerns play dominant role.Keywords:BIO MTA+; Biodentine; wMTA Angelus; EndoSequence Root Repair Material; Color Stability;

Objective: Present in-vitro study aimed to evaluate the apical leakage of different bioceramic retrofilling materials with and without smear layer.Materials and Methods: : Sixty human single-rooted teeth were decoronated at a standardized root length of 13 mm, chemo-mechanically prepared and obturated. After obturation, root-end resection was done and root-end cavities were prepared using ultrasonic tips. The specimens with prepared retro cavities were randomly assigned into 2 groups (n = 30) based on the smear layer removal protocol used. Each group was further subdivided into 3 subgroups (n = 10) based on the bioceramic retrofilling material MTA (Mineral Trioxide Aggregate; Proroot Dentsply/Tulsa), CEM (Calcium-Enriched Mixture; Bionique Dent, Tehran) and ERRM (EndoSequence® Root Repair Material; Brasseler USA, Savannah, GA). The extension of dye (2% Rhodamine B) penetration was measured in millimetre using a stereomicroscope at 10× zoom. Results were statistically analysed using one-way ANOVA (analysis of variance) test and unpaired Student's t test.Results: In the presence of smear layer, MTA demonstrated maximum mean apical leakage value (1.70 ± 0.30), followed by CEM (1.40 ± 0.37) and ERRM (1.40 ± 0.23), which was statistically not significant. Without the smear layer, ERRM demonstrated the least mean apical leakage value, which was statistically significant as compared with CEM (P <.05) and MTA (P <.01).Conclusion(s): : All bioceramic retrofilling materials demonstrated apical leakage irrespective of the presence or absence of the smear layer. The presence of a smear layer is beneficial for the sealing ability of MTA and CEM, whereas, the absence of the smear layer is advocated while using ERRM. [ABSTRACT FROM AUTHOR]

Introduction: The introduction of mineral trioxide aggregate (MTA) and bioceramic sealers increased the success rate of endodontic surgery and perforation repair. The aim of this study was to evaluate the marginal adaptation at different times of endosequence root repair material (ERMM) in order to evaluate its dimensional stability using variable pressure-scanning electron microscope (VP-SEM). Material And Methods: Fourty-eight teeth were selected shaped up to a master apical size of 25. Then a 3 mm cut perpendicular to the long axis and a retrograde cavity preparation were performed. In order to obtain 2 mm thick sample a second cut was done and, in this disk, ERMM was inserted. The samples were stored at 37°. The samples were divided into four time-depending groups observed with VP-SEM at time 0 (Group 1) and after 2 (Group 2), 7 (Group 3) and 30 days (Group 4) after ERRM setting. Statistical analysis with one way-ANOVA test was performed (95%). Results: None of the four groups analyzed showed a complete marginal adaptation between dentin and ERRM. Instead, in all groups ERRM exhibited a completely preserved marginal adaptation to the dentin wall in all time-dependent groups. The mean (±SD) gap value was for time 0, 3.91 (±2.55) µm after 2 days, 4.32 (±2.69), after 7 days 4.49 (±2.53), and after 30 days 4.81 (±2.85) µm. No statistically significant difference was found between the four groups. Conclusions: The results of the present study demonstrate the dimensional stability over time of ERMM.

Background: Apical plug formation by mineral trioxide aggregate (MTA), Biodentine, and EndoSequence root repair material (RRM) is an excellent alternative technique to the conventional apexification procedure. Several antimicrobial agents have been incorporated in MTA and Biodentine to boost their antimicrobial efficacy. Considering the polymicrobial nature of root canal infection, a combination of potent antimicrobials like triple antibiotic powder (TAP) would be needed to address the diverse flora encountered. Calcium release is the consequential factor in the clinical excellence of these cements. Aim: The aim of the study was to evaluate and compare the calcium released from the apical plugs formed by MTA, Biodentine, and EndoSequence RRM with and without incorporation of 2% TAP. Methods: Ninety single-rooted teeth were divided into (n = 15) Group A: MTA + 2% TAP, Group B: MTA, Group C: Biodentine + 2% TAP, Group D: Biodentine, Group E: EndoSequence RRM + 2% TAP, and Group F: EndoSequence RRM to form the 4 mm apical plugs. Each sample tooth was then immersed in 10 ml of deionized water. Evaluation of calcium release was done on days 7, 15, and 30 using an atomic absorption spectrophotometer. Data were analyzed using one-way analysis of variance, post hoc test, and unpaired t-test. Results: Calcium released was maximum for Group E compared to Group F (P < 0.05), maximum for Group C compared to Group D, and was maximum for Group A compared to Group B (P < 0.05) at days 7, 15 and 30. Conclusion: Incorporation of 2% TAP resulted in increased calcium ions released from MTA, Biodentine, and EndoSequence RRM.

The root perforation, in spite of being taken as a challenging accident in root canal treatment, has to offer favorable results when exposed to appropriate therapeutic conduct and the usage of materials that have convenient properties. The aim of the current review is to collect all updated and available studies including imperative information concerning the use of Mineral trioxide aggregate, EndoSequence root repair material and Biodentine in the treatment of root perforation approaching some of the key properties for treatment success. A search was performed in the two automated databases (Google Scholar and PubMed use English-language literature) for this systematic review, using specific inclusion and exclusion criteria and keywords. The electronic search was done in December 2018 and update in June 2019. Our inquiry uncovered Twenty-two studies that met the exclusion and inclusion criteria. These studies investigated the use of MTA, EndoSequence ERRM and Biodentine in the root perforation that happened during the endodontic treatment. It was confirmed that there is no unanimity in this review concerning the material that shows the best characteristics, once none of the materials discussed had all the major properties higher than the others, this way it is required the enforcement of further studies aimed at selecting the best characteristics of the material suggested in the root perforation treatment.

Purpose This study aimed to evaluate the effects of 17% ethylenediaminetetraacetic acid (EDTA), 7% maleic acid (MA), and 10% citric acid (CA) on the push-out bond strength of ProRooT MTA and Endosequence Root Repair Material (ERRM) putty. Materials and Methods Eighty single-rooted extracted human teeth were instrumented to obtain a standardized immature teeth model. Based on the chelating agents tested, the specimens were randomly divided into three experimental groups: Group 1 (17% EDTA), Group 2 (7% MA), Group 3 (10% CA), and Group 4 (Positive Control) (n=20 for each group). Each group was further classified into two subgroups: Group A (ProRoot MTA) and Group B (Endosequence Root Repair Material (ERRM) putty) (n=10 for each subgroup). After irrigation and placement of cements, teeth were stored at 37°C and in 100% humidity for a week. A total of 240 dentine discs (three discs per teeth) were obtained and subjected to push-out assay. Data was analyzed using two-way analysis of variance and Tukey’s post hoc t-test. Results Both types of chelating agent and calcium silicate-based cement were significantly associated with the push-out bond strength values. The push-out bond strength was significantly less for CA as compared to EDTA or MA. ERRM had higher bond strength values than ProRoot MTA (p

Background: Perforations can occur during any endodontic procedure which may affect prognosis if not repaired immediately. During perforation repair, various irrigating solutions were used which may affect the bond strength of repair materials. Methods: In this study, sixty dentin slices of 2 mm thickness were prepared with lumen 1.3 mm. Samples were divided into two groups. Biodentine and EndoSequence Root Repair Material (RRM) were placed in the respective samples and incubated for 24 h. Subdivision of groups into three was done: control, 17% ethylenediaminetetraacetic acid (EDTA), and QMix. Immersion was done for 30 min, followed by incubation for 48 h. The samples were then tested for compressive strength through a push-out test. The mean, standard deviation, median, and range of bond strength of EndoSequence Bioceramic RRM and Biodentine were obtained. One-way analysis of variance was used to determine the statistical significance of difference in the mean push-out strengths of each material across decalcifying agents. Paired analysis of push-out strength between decalcifying agents for each material was performed using Tukey's post hoc test. All the analyses were performed using R-3.0.0 programming language, and the statistical confidence was tested at 95%. Results: Results showed that EndoSequence RRM had superior bond strength than Biodentine. 17% EDTA and QMix showed negative influence on the bond strength. However, QMix samples had more bond strength than 17% EDTA. Conclusion: QMix showed less negative influence than EDTA on Biodentine and EndoSequence RRM. [ABSTRACT FROM AUTHOR]

Dental pulp-capping is done to preserve vital teeth when the pulp is exposed due to caries, trauma or instrumentation. Various materials are used as pulp-capping agents. The introduction of newer materials requires scientific studies to assess their clinical efficacy. The study was designed as a split-mouth randomized analysis of four pulp-capping agents (calcium hydroxide, mineral trioxide aggregate (MTA), Biodentine and EndoSequence root repair material (ERRM)). Based on selection criteria, 15 orthodontic patients requiring the extraction of four premolars (60 teeth total) were included in the study. After pulp-capping, the teeth were extracted after 8 weeks. We analyzed the extracted teeth using cone-beam computed tomography (CBCT) and histological sections to determine the quality of the dentinal bridge and the pulpal response. Ordinal scores were given based on the completeness of the dentinal bridge, the type of bridge and the degree of pulpal inflammation. Results were analyzed using a Kruskal–Wallis test (p < 0.05) with post hoc Conover values being used when applicable. All four pulp-capping materials elicited dentinal bridge formation (60/60). MTA had the highest scores (10/15) in dentinal bridge formation followed by ERRM (8/15). Both materials showed more samples with complete dentinal bridges (9/15 each) and a favorable pulpal response (15/15). Teeth capped with calcium hydroxide showed more cases of incomplete bridge formation (9/15) and pulpal inflammation. These differences in dentinal bridge formation and pulpal inflammation were statistically significant (p 0.001 and p 0.00005, respectively), with post hoc tests revealing no significant differences between MTA and ERRM (p 0.49 and p 0.71, respectively). MTA and ERRM performed better than the other pulp-capping materials but did not differ significantly from each other. The individual preference for a pulp-capping material may be based on clinical efficacy and handling characteristics. [ABSTRACT FROM AUTHOR]

Objective: To compare the sealing ability of ProRoot mineral trioxide aggregate (MTA) to the sealing ability of EndoSequence Bioceramic Root Repair Material (ES-BCRR) putty using a bacterial leakage model. Method and Materials: Root canals of 60 single-rooted extracted teeth were enlarged to an apical diameter of 0.5 mm using EndoSequence files. The apical 3 mm of each root was sectioned at 90 degrees to the long axis of the root. An ultrasonic surgical tip was used to prepare a 3-mm deep root-end preparation in all teeth. Teeth were equally divided into four groups: Group 1, MTA; Group 2, ES-BCRR putty; Group 3, positive control, gutta-percha without sealer; Group 4, negative control, sealed with wax and nail varnish. Prepared teeth were kept moist for 48 hours to allow for initial setting of the materials. After ethylene oxide sterilization, the teeth were suspended in sterilized vials containing 3% phenol lactose broth and inoculated with Enterococcus faecalis through the occlusal access openings. The samples were observed daily for leakage to a maximum of 28 days. Chi-square and Fisher exact tests were used to compare the experimental groups and an alpha level of significance was set at P = .05. Results: In the ES-BCRR group 93% of samples leaked, compared to only 20% of samples in the MTA group. There was a significant difference in leakage between the experimental groups (P < .0001). Also there were no significant differences between the negative control group and MTA group and between the positive control group and ES-BCRR group (P = 1.00). Conclusion: Samples in the ES-BCRR group leaked significantly more than samples in the MTA group. [ABSTRACT FROM AUTHOR]

Background: Apical plug formation by mineral trioxide aggregate (MTA), Biodentine, and EndoSequence root repair material (RRM) is an excellent alternative technique to the conventional apexification procedure. Several antimicrobial agents have been incorporated in MTA and Biodentine to boost their antimicrobial efficacy. Considering the polymicrobial nature of root canal infection, a combination of potent antimicrobials like triple antibiotic powder (TAP) would be needed to address the diverse flora encountered. Calcium release is the consequential factor in the clinical excellence of these cements.Aim: The aim of the study was to evaluate and compare the calcium released from the apical plugs formed by MTA, Biodentine, and EndoSequence RRM with and without incorporation of 2% TAP.Methods: Ninety single-rooted teeth were divided into (n = 15) Group A: MTA + 2% TAP, Group B: MTA, Group C: Biodentine + 2% TAP, Group D: Biodentine, Group E: EndoSequence RRM + 2% TAP, and Group F: EndoSequence RRM to form the 4 mm apical plugs. Each sample tooth was then immersed in 10 ml of deionized water. Evaluation of calcium release was done on days 7, 15, and 30 using an atomic absorption spectrophotometer. Data were analyzed using one-way analysis of variance, post hoc test, and unpaired t-test.Results: Calcium released was maximum for Group E compared to Group F (P < 0.05), maximum for Group C compared to Group D, and was maximum for Group A compared to Group B (P < 0.05) at days 7, 15 and 30.Conclusion: Incorporation of 2% TAP resulted in increased calcium ions released from MTA, Biodentine, and EndoSequence RRM. [ABSTRACT FROM AUTHOR]

The purpose of this retrospective study was to determine the clinical and radiographic outcomes of root-end microsurgery in a postgraduate program in endodontics using modern techniques and calcium silicate–based root-end filling materials (ProRoot MTA; Dentsply International, Johnson City, TN, and EndoSequence Root Repair Material [ERRM]; Brasseler USA, Savannah, GA) and to identify any potential prognostic factors that may have affected healing outcomes. Clinical records and periapical radiographs were collected from patients who had undergone endodontic microsurgery between 2007 and 2018 in a postgraduate endodontic clinic with a minimum follow-up interval of 6 months. Either ProRoot MTA or ERRM was used as the root-end filling material. Outcomes were categorized into healed, healing, and nonhealing based on clinical and radiographic findings. Healed and healing cases were pooled and considered as successes, whereas nonhealing cases were considered as failures. A total of 129 patients with 142 teeth were included in the final analysis. Seventy-six cases were root-end filled with ProRoot MTA and 66 root-end filled with ERRM. The ProRoot MTA group had a success rate of 92.1%, and the ERRM group had a success rate of 92.4% with no significant difference between the groups (P >.05). Vertical root fracture was found to be the predominant cause of failure. No patient- or treatment-related factor was identified to have any significant impact on healing. High overall success can be achieved in a postgraduate endodontic program when either ProRoot MTA or ERRM is used as the root-end filling material. [ABSTRACT FROM AUTHOR]

Introduction: Various materials have been tried to minimise tooth discolouration over the years. Calcium silicatebased cements have been available for many years. These biomaterials have been used in various endodontic treatments including repair of tooth perforations, as root end restorations, in conditions of open apices, as pulp capping agent and in apexification procedures. Calcium-based materials have shown discolouration with time, minimising the discolouration has become a necessity especially in the teeth in the aesthetic zone. Biomaterial are non-viable material that can be implanted to replace or repair lost tissue, which can be bone substitute, collagen membrane and matrices which are commonly used in regenerative dentistry. Mineral Trioxide Aggregate (MTA) is a biomaterial which has shown discolouration over time. There are various radio-opacifiers like zirconium oxide, tantalum oxide which are been introduced to replace the bismuth oxide which is supposed to be the main reason for discolouration. The study is conducted to compare the rate of discolouration among three different materials over a period of three months. Aim: To determine the tooth discolouration between the ProRoot MTA, ENDOCEM-Zr, and EndoSequence Root Repair Material (ERRM) at baseline, one week, one month and three months using Spectrophotometric analysis. Materials and Methods: A total of 40 extracted human maxillary central incisors were collected for the in-vitro study. Experimental group consisted of ProRoot MTA (Group 1), Endocem-Zr (Group 2), ERRM (Group 3) and one control group. Three different root end filling materials (ProRoot MTA, Endocem-Zr, ERRM) were placed in retrograde pattern after chemomechanical preparation of root canal system whereas in the control group, the pulp tissue was extirpated from the teeth, which were then only sealed with composite resin. Colour assessment was done immediately after the placement of material in the cavity (baseline) and at one week (T1), one month (T2) and three months (T3). Colour values were recorded by a single operator using a spectrophotometer (X-rite i1 pro spectrophotometer). Repeated measures analysis of variance was carried out to determine the significant difference in the discolouration among the four groups namely, ProRoot MTA, ENDOCEM-Zr, ERRM and control across the three time points. Results: It was found that statistically significant difference existed between reading taken from baseline and 30 days, than 30 days to 90 days. MTA had shown steady increase in discolouration over a period of three months and showed statistically significant results whereas the other two materials had decreased discolouration over the period of three months and showed less distinct values. Conclusion: EndoSequence Root Repair Material and Endocem-Zr had shown lesser discolouration over a period of three months, Endocem-Zr showed lesser discolouration when compared to that of EndoSequence Repair material which showed rapid decrease in discolouration from one month to three months whereas MTA showed steady increase in discolouration with time. Endocem-Zr showed lesser discolouration than ERRM in a period of three months.

Introduction: The introduction of mineral trioxide aggregate (MTA) and bioceramic sealers increased the success rate of endodontic surgery and perforation repair. The aim of this study was to evaluate the marginal adaptation at different times of endosequence root repair material (ERMM) in order to evaluate its dimensional stability using variable pressure-scanning electron microscope (VP-SEM). Material And Methods: Fourty-eight teeth were selected shaped up to a master apical size of 25. Then a 3mm cut perpendicular to the long axis and a retrograde cavity preparation were performed. In order to obtain 2mm thick sample a second cut was done and, in this disk, ERMM was inserted. The samples were stored at 37°. The samples were divided into four time-depending groups observed with VP-SEM at time 0 (Group 1) and after 2 (Group 2), 7 (Group 3) and 30 days (Group 4) after ERRM setting. Statistical analysis with one way-ANOVA test was performed (95%). Results: None of the four groups analyzed showed a complete marginal adaptation between dentin and ERRM. Instead, in all groups ERRM exhibited a completely preserved marginal adaptation to the dentin wall in all time-dependent groups. The mean (±SD) gap value was for time 0, 3.91 (±2.55)mm after 2 days, 4.32 (±2.69), after 7 days 4.49 (±2.53), and after 30 days 4.81 (±2.85)mm. No statistically significant difference was found between the four groups. Conclusions: The results of the present study demonstrate the dimensional stability over time of ERMM. [ABSTRACT FROM AUTHOR]

Introduction: iRoot BP Plus, also known as EndoSequence root repair material (EERM) is a premixed bioceramic thick/putty. According to its instruction manual, iRoot BP Plus is composed of tricalcium silicate, zirconium oxide, tantalum pentoxide, dicalcium silicate, calcium sulfate, calcium phosphate monobasic, and filler agents. This systematic review was carried out to evaluate and present the iRoot BP Plus material as a pulp-capping agent. Materials and Methods: A systematic search for articles with the scope of the selection criteria undergoing for data extraction was conducted through electronic databases. Studies on evaluation of the cytotoxicity, bioactivity, and dentinal bridge formation of iRoot BP, iRoot BP Plus, ERRM putty, or ERRM paste (ERRM) on variant human cells were selected for in vitro models, and dentinal bridge formation on human and animals teeth for in vivo models were selected. Results: A total of 22 articles were discussed in the review, 14 in vitro studies, five in vivo studies, and three articles with both studies. Methyl thiazol tetrazolium was the most used method for evaluating cytotoxicity. As for dentinal bridge formation, histological assessment and micro-Computed tomography were used. Human dental pulp cells (hDPCs) were the most investigated for in vitro models and rats for in vivo models. Except for one study, all studies involved in this review were primarily examining the material and comparing it to different types of mineral trioxide aggregate. Conclusion: iRoot BP, iRoot BP Plus, and ERRM are biocompatible materials that enhance hDPCs and other variant human cells proliferation, migration, attachment adhesion, mineralization, and dentinal bridge formation. [ABSTRACT FROM AUTHOR]

Purpose This study aimed to evaluate the effects of 17% ethylenediaminetetraacetic acid (EDTA), 7% maleic acid (MA), and 10% citric acid (CA) on the push-out bond strength of ProRooT MTA and Endosequence Root Repair Material (ERRM) putty. Materials and Methods Eighty single-rooted extracted human teeth were instrumented to obtain a standardized immature teeth model. Based on the chelating agents tested, the specimens were randomly divided into three experimental groups: Group 1 (17% EDTA), Group 2 (7% MA), Group 3 (10% CA), and Group 4 (Positive Control) (n=20 for each group). Each group was further classified into two subgroups: Group A (ProRoot MTA) and Group B (Endosequence Root Repair Material (ERRM) putty) (n=10 for each subgroup). After irrigation and placement of cements, teeth were stored at 37°C and in 100% humidity for a week. A total of 240 dentine discs (three discs per teeth) were obtained and subjected to push-out assay. Data was analyzed using two-way analysis of variance and Tukey's post hoc t-test. Results Both types of chelating agent and calcium silicate-based cement were significantly associated with the push-out bond strength values. The push-out bond strength was significantly less for CA as compared to EDTA or MA. ERRM had higher bond strength values than ProRoot MTA (p<0.05). Conclusion The use of chelating agents increased the push-out bond strength of CSC. Regardless of tested chelating agents, ERRM had higher bond strength values than ProRoot MTA. [ABSTRACT FROM AUTHOR]

Introduction: Various materials have been tried to minimise tooth discolouration over the years. Calcium silicatebased cements have been available for many years. These biomaterials have been used in various endodontic treatments including repair of tooth perforations, as root end restorations, in conditions of open apices, as pulp capping agent and in apexification procedures. Calcium-based materials have shown discolouration with time, minimising the discolouration has become a necessity especially in the teeth in the aesthetic zone. Biomaterial are non-viable material that can be implanted to replace or repair lost tissue, which can be bone substitute, collagen membrane and matrices which are commonly used in regenerative dentistry. Mineral Trioxide Aggregate (MTA) is a biomaterial which has shown discolouration over time. There are various radio-opacifiers like zirconium oxide, tantalum oxide which are been introduced to replace the bismuth oxide which is supposed to be the main reason for discolouration. The study is conducted to compare the rate of discolouration among three different materials over a period of three months. Aim: To determine the tooth discolouration between the ProRoot MTA, ENDOCEM-Zr, and EndoSequence Root Repair Material (ERRM) at baseline, one week, one month and three months using Spectrophotometric analysis. Materials and Methods: A total of 40 extracted human maxillary central incisors were collected for the in-vitro study. Experimental group consisted of ProRoot MTA (Group 1), Endocem-Zr (Group 2), ERRM (Group 3) and one control group. Three different root end filling materials (ProRoot MTA, Endocem-Zr, ERRM) were placed in retrograde pattern after chemomechanical preparation of root canal system whereas in the control group, the pulp tissue was extirpated from the teeth, which were then only sealed with composite resin. Colour assessment was done immediately after the placement of material in the cavity (baseline) and at one week (T1), one month (T2) and three months (T3). Colour values were recorded by a single operator using a spectrophotometer (X-rite i1 pro spectrophotometer). Repeated measures analysis of variance was carried out to determine the significant difference in the discolouration among the four groups namely, ProRoot MTA, ENDOCEM-Zr, ERRM and control across the three time points. Results: It was found that statistically significant difference existed between reading taken from baseline and 30 days, than 30 days to 90 days. MTA had shown steady increase in discolouration over a period of three months and showed statistically significant results whereas the other two materials had decreased discolouration over the period of three months and showed less distinct values. Conclusion: EndoSequence Root Repair Material and Endocem-Zr had shown lesser discolouration over a period of three months, Endocem-Zr showed lesser discolouration when compared to that of EndoSequence Repair material which showed rapid decrease in discolouration from one month to three months whereas MTA showed steady increase in discolouration with time. Endocem-Zr showed lesser discolouration than ERRM in a period of three months. [ABSTRACT FROM AUTHOR]

Dental pulp-capping is done to preserve vital teeth when the pulp is exposed due to caries, trauma or instrumentation. Various materials are used as pulp-capping agents. The introduction of newer materials requires scientific studies to assess their clinical efficacy. The study was designed as a split-mouth randomized analysis of four pulp-capping agents (calcium hydroxide, mineral trioxide aggregate (MTA), Biodentine and EndoSequence root repair material (ERRM)). Based on selection criteria, 15 orthodontic patients requiring the extraction of four premolars (60 teeth total) were included in the study. After pulp-capping, the teeth were extracted after 8 weeks. We analyzed the extracted teeth using cone-beam computed tomography (CBCT) and histological sections to determine the quality of the dentinal bridge and the pulpal response. Ordinal scores were given based on the completeness of the dentinal bridge, the type of bridge and the degree of pulpal inflammation. Results were analyzed using a Kruskal–Wallis test (p < 0.05) with post hoc Conover values being used when applicable. All four pulp-capping materials elicited dentinal bridge formation (60/60). MTA had the highest scores (10/15) in dentinal bridge formation followed by ERRM (8/15). Both materials showed more samples with complete dentinal bridges (9/15 each) and a favorable pulpal response (15/15). Teeth capped with calcium hydroxide showed more cases of incomplete bridge formation (9/15) and pulpal inflammation. These differences in dentinal bridge formation and pulpal inflammation were statistically significant (p 0.001 and p 0.00005, respectively), with post hoc tests revealing no significant differences between MTA and ERRM (p 0.49 and p 0.71, respectively). MTA and ERRM performed better than the other pulp-capping materials but did not differ significantly from each other. The individual preference for a pulp-capping material may be based on clinical efficacy and handling characteristics.

This study aimed to evaluate the effect of intracanal placement of various medicaments on the bond strength of ProRooT MTA, Biodentine, and Endosequence root repair material (ERRM) putty. Ninety extracted human mandibular premolar teeth were decoronated and instrumented using Protaper Next rotary system and #1 to #6 Peeso reamers. The prepared teeth were randomly divided into six groups according to the intracanal medicaments: Group 1: double antibiotic paste (DAP) consisting of metronidazole and ciprofloxacin; Group 2: Triple antibiotic paste (TAP) with cefaclor; Group 3: TAPwith clindamycin; Group 4: amoxicillin and clavulanic acid (Augmentin®); Group 5: calcium hydroxide (CH); Group 6: control (no medicament) (n = 15). Parallel transverse sections were obtained in the coronal to the apical direction (4 slices/ tooth) and were divided into three subgroups according to the cements: Group A: ProRoot MTA; Group B: Biodentine; Group C: ERRM (n = 20 slices/subgroup). A push-out test was used to measure bond strength. Data were analyzed using two-way analysis of variance and Tukey’spost hoctest. The bond strength was significantly lower for DAP and TAPs than for Augmentin®, CH, or the control (p < 0.05). Biodentine and ERRM had significantly higher bond strength values than ProRooT MTA (p < 0.05) regardless of the intracanal medicaments tested, while no significant difference existed between Biodentine and ERRM (p > 0.05). While the application of DAP or TAPs decreased the bond strength, application of CH or Augmentin® did not. ERRM and Biodentine had higher bond strength values than ProRoot MTA. [ABSTRACT FROM PUBLISHER]

Introduction: The purpose of this study was to compare the push-out bond strength of white ProRoot Mineral Trioxide Aggregate (MTA), Biodentine, calcium-enriched mixture (CEM) cement and Endosequence Root Repair Material (ERRM) putty after exposure to blood. Methods and Materials: A total of 96 root dentin slices with a standardized thickness of 1.00±0.05 mm and standardized canal spaces were randomly divided into 4 main experimental groups (n=24) according to the calcium silicate based cement (CSC) used: white ProRoot MTA, CEM Cement, ERRM Putty and Biodentine. Specimens were exposed to whole fresh human blood and then subdivided into two subgroups depending on the exposure time (24 or 72 h). Push-out bond strength was measured using a universal testing machine. Failure modes were examined under a light microscope under ×10 magnification. Data were analyzed using the two-way ANOVA test. Results: Biodentine exhibited the highest values regardless of the exposure time. The lowest push-out strength values were seen in white ProRoot MTA and CEM cement in both post exposure times. After exposure to blood, the push-out bond strength of all materials increased over time. This increase was only statistically significant in white ProRoot MTA and ERRM specimens. The dominant failure mode in all CSCs was the adhesive mode. Conclusion: Biodentine showed the highest values of push-out bond strength and may be better options for situations encountering higher dislocation forces in a short time after cement application. [ABSTRACT FROM AUTHOR]

Introduction The aim of this study was to evaluate the subcutaneous connective tissue response to EndoSequence root repair paste (Brasseler, Savannah, GA) compared with mineral trioxide aggregate (MTA). Methods Thirty-six Wistar rats each received 3 sterile tubes, containing 1 of the tested materials and control. The animals were killed 1, 3 and 6 weeks after implantation. The specimens were evaluated histologically for type of inflammation, intensity and extent of inflammatory cells, foreign body reaction, fibrous capsule thickness, perivascular fragments, calcific deposits and vascular congestion. Results EndoSequence provoked severe inflammation after 1 week, which was significantly different from MTA and control ( P ˂ .05), with fragmented particles and foreign body reaction. MTA showed tissue-tolerance features almost comparable to control. Conclusions EndoSequence was significantly more irritating than MTA and control at 1 and 3 weeks in terms of severity and extent of inflammation. After 6 weeks it displayed more biocompatible characteristics. [ABSTRACT FROM AUTHOR]

Introduction The ability to promote osteoblast differentiation is a desirable property of root-end filling materials. Several in vitro studies compare the cytotoxicity and physical properties between mineral trioxide aggregate (MTA) and Endosequence root repair material (ERRM), but not their osteogenic potential. Three-dimensional cultures allow cells to better maintain their physiological morphology and better resemble in vivo cellular response than 2-dimensional cultures. Here we examined the osteogenic potential of MTA and ERRM by using a commercially available 3-dimensional Alvetex scaffold. Methods Mandibular osteoblasts were derived from 3-week-old male transgenic reporter mice where mature osteoblasts express green fluorescent protein (GFP) driven by a 2.3-kilobase type I collagen promoter ( Col(I) - 2.3 ). Mandibular osteoblasts were grown on Alvetex in direct contact with MTA, ERRM, or no material (negative control) for 14 days. Osteoblast differentiation was evaluated by expression levels of osteogenic genes by using quantitative polymerase chain reaction and by the spatial dynamics of Col(I) - 2.3 GFP-positive mature osteoblasts within the Alvetex scaffolds by using 2-photon microscopy. Results ERRM significantly increased alkaline phosphatase ( Alp ) and bone sialoprotein ( Bsp ) expression compared with MTA and negative control groups. Both MTA and ERRM increased osterix ( Osx ) mRNA significantly compared with the negative control group. The percentage of Col(I)-2.3 GFP-positive cells over total cells within Alvetex was the highest in the ERRM group, followed by MTA and by negative controls. Conclusions ERRM promotes osteoblast differentiation better than MTA and controls with no material in a 3-dimensional culture system. Alvetex scaffolds can be used to test endodontic materials. [ABSTRACT FROM AUTHOR]

Introduction The purpose of this study was to evaluate coronal tooth discoloration of ProRoot MTA (Dentsply Tulsa Dental, Johnson City, TN), white ProRoot MTA, EndoSequence Root Repair Material (Brasseler USA, Savannah, GA), MTA Angelus (Angelus Solucoes Odontologicas, Londrina, Brazil), and Biodentine (Septodont, Saint Maur des Fosses, France) when used in an ex vivo pulpotomy model. Methods Freshly extracted mandibular third molars were collected and stored in 1% chloramine-T solution. Teeth were randomly assigned into 6 groups ( n = 15) and stored individually in phosphate buffered saline at 37°C in 100% humidity. A standardized endodontic access was made in 5 groups. A 3-mm-thick increment of reparative material was placed on the pulpal floor, covered by glass ionomer, and the access opening restored with composite. Color (Commission Internationale de l'eclairage L*a*b*) was recorded with the Vita Easy Shade spectrophotometer (VITA Zahnfabrik, Bad Säckingen, Germany) on the midbuccal surface at baseline; after access preparation; after material placement; and then after 1, 7, 30, and 60 days. Changes in Commission Internationale de l'eclairage L*a*b* were measured for each experimental group and compared with ProRoot MTA (positive control) and no treatment (negative control) using the following equation: ΔE = ([Li − L0*] 2 + [ai − a0*] 2 + [bi − b0*] 2 ) 1/2 . The mean results were analyzed within each group and between groups using the Friedman 2-way analysis post hoc test ( P < .05). Results There were no significant differences between white ProRoot MTA, MTA Angelus, and the positive control group. EndoSequence Root Repair Material and Biodentine produced significantly less discoloration than white ProRoot MTA, MTA Angelus, and ProRoot MTA. Conclusions Under the conditions of this study, EndoSequence and Biodentine had significantly less discoloration compared with white ProRoot MTA, MTA Angelus, and ProRoot MTA. The potential for discoloration may or may not correlate when materials are used clinically. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the effect of an acidic environment on dislocation resistance (push-out bond strength) of EndoSequence Root Repair Material (ERRM putty and ERRM paste), a new bioceramic-based material, to that of mineral tri-oxide aggregate (MTA).One-hundred twenty root dentin slices with standardized canal spaces were divided into 6 groups (n = 20 each) and filled with tooth-colored ProRoot MTA (groups 1 and 2), ERRM putty (groups 3 and 4), or ERRM paste (groups 5 and 6). The specimens of groups 1, 3, and 5 were exposed to phosphate buffered saline (PBS) solution (pH=7.4) and those of groups 2, 4, and 6 were exposed to butyric acid (pH= 4.4). The specimens were then incubated for 4 days at 37°C. The push-out bond strength was then measured using a universal testing machine. Failure modes after the push-out test were examined under a light microscope at ×40 magnification. The data for dislocation resistance were analyzed using the t-test and one-way analysis of variance.In PBS environment (pH=7.4), there were no significant differences among materials (P=0.30); but the mean push-out bond strength of ERRM putty was significantly higher than that of other materials in an acidic environment (P

Introduction: Biodentine (Septodont, Saint Maur des Fossés, France), OrthoMTA (BioMTA, Seoul, Korea), and EndoSequence Root Repair Material (ERRM; Brasseler, Savannah, GA) have been developed to overcome the shortcomings of mineral trioxide aggregate (MTA). The purpose of this study was to compare tooth discoloration after the application of ProRoot MTA (Dentsply Tulsa Dental Products, Tulsa, OK) and 3 recently introduced calcium silicate-based cements in the presence and absence of blood. Methods: In total, 104 human anterior teeth were prepared; 96 were randomly divided into 2 groups (blood and saline contamination). Each group was subdivided into 4 experimental subgroups (n = 12) of ProRoot MTA, Biodentine, OrthoMTA, and ERRM that were used to fill the pulp chambers. The remaining 8 teeth served as the saline and blood groups. Color analysis of tooth crowns was performed using a spectroradiometer before the application of materials and at 24 hours, 1 month, and 6 months after application. Repeated measures analysis of variance was used to evaluate the effects of blood, material, and time on color change (ΕE*). Results: Tooth color change in all experimental groups increased over time (P < .05). Blood contamination significantly increased ΕE* (P < .05), but no significant difference occurred between the 4 groups in this respect in the presence of blood. However, in the absence of blood, the ΕE* of Biodentine and ERRM was significantly less than that of OrthoMTA (P < .05). Conclusions: There was no significant difference between tooth discolorations with materials in the presence of blood. However, in the absence of blood, Biodentine and ERRM exhibited less tooth discoloration than OrthoMTA. [ABSTRACT FROM AUTHOR]

Introduction: Pulp capping techniques aim at preserving the vitality of pulp tissue, thus avoiding more invasive endodontic procedures. Endosequence Root Repair Material (ERRM; Brasseler USA, Savannah, GA) has been recently introduced as a potential pulp capping material. It is hypothesized that ERRM promotes the healing of dental tissue, thus maintaining the integrity and vitality of the pulp after pulp capping procedures. However, the exact mechanism by which ERRM affects the pulp after pulp capping procedures is still unknown. Therefore, the aim of this research was to delineate the effects of ERRM on the dental pulp and compare these effects to those of ProRoot MTA. Methods: The effects of ERRM on dental pulp cells (DPCs) were compared with ProRoot mineral trioxide aggregate (MTA) (Tulsa Dental, Tulsa, OK). The effects of the 2 materials on the cells were analyzed using various assays such as flow cytometric analysis using FITC Annexin V and PI (BD Biosciences, Franklin Lakes, NJ), WST-1 proliferation assay (Millipore, Billerica, MA), vascular endothelial growth factor (VEGF) enzyme-linked immunosorbent assay, and an alkaline phosphatase (ALP) assay. Results were analyzed using analysis of variance with a post hoc Tukey test and the level of significance set at P # .05. Results: The results showed that DPCs had similar percentages of viable cells when grown on either material. Furthermore, the proliferation rates, secretion of VEGF, and levels of ALP were similar for DPCs when cultured on either ERRM or ProRoot MTA. Conclusions: Overall, this study showed similar survival and proliferation of DPCs when in contact with ERRM or ProRoot MTA, which could make it a suitable alternative for pulp capping procedures. [ABSTRACT FROM AUTHOR]

This study compared the push-out bond strength of EndoSequence Root Repair Material (ERRM) and Bioaggregate (BA), new bioceramic materials, to that of mineral trioxide aggregate (MTA) after incubation in phosphate-buffered saline (PBS), a synthetic tissue fluid, for either 1 week or 2 months.One-hundred and twenty root sections were filled with ProRoot MTA, BA, or ERRM. Each tested material was then randomly divided into two subgroups (n = 20): root sections were immersed in PBS for 1 week or 2 months. The bond strengths were measured using a universal testing machine. After that, the failure modes were examined with stereomicroscopy and scanning electron microscopy (SEM). The push-out data and failure mode categories were analyzed by two-way ANOVA and chi-square tests, respectively.The bond strength of ERRM was significantly higher than that of BA and MTA at both incubation periods. No significant difference was found between the bond strength of MTA and BA at either 1 week or 2 months. Increasing the incubation time to 2 months resulted in a significant increase in bond strength of all the materials. The failure mode was mainly mixed for MTA and BA, but cohesive for ERRM at both incubation periods.ERRM had significantly higher bond strength to root canal walls compared to MTA and BA. Increasing the incubation time significantly improved the bond strength and bioactive reaction products of all materials.

Introduction The purpose of this study was to investigate the antifungal activity of Endosequence Root Repair Material (ERRM; Brasseler USA, Savannah, GA) as compared with mineral trioxide aggregate (MTA) using Candida albicans . Methods All materials were packed into sterilized intravenous tubing to obtain standardized samples and allowed to set for 3 or 24 hours and then exposed to a suspension of C. albicans for incubations of 24 or 48 hours. To analyze the mechanisms of the material's antifungal activity, additional samples of each test material were prepared in the same manner and allowed to set for 24 hours; these were then incubated in a culture medium for 24 hours. The pH of each conditioned media was measured before transferring to wells containing C. albicans . The development of biofilm was analyzed after 24 and 48 hours with 2,3-bis (2-methoxy-4-nitro-5-sulfophenyl)-5-([phenyl amino] carbonyl)-2H-tetrazolium hydroxide reduction assay. Results Materials in both experimental groups significantly limited biofilm formation at each interval (ie, 24 and 48 hours). After incubating for a 24-hour period in the presence of C. albicans , ERRM in both experimental groups showed a reduction in biofilm formation that was statistically significant in comparison with MTA. However, when set for 24 hours and incubated for 48 hours, gray MTA and white MTA showed a more substantial reduction in biofilm formation than comparable samples of ERRM. Cultured media conditioned with test materials showed statistically significant antifungal biofilm activity after 48 hours. Conclusions All materials tested have comparable antifungal biofilm activity. It appeared that changing the environment, such as the pH, contributed to this activity. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Procedures used in single-visit or multiple-visit approaches to apical barrier creation were used with an experimental apexification model to test the surface hardness of 3 materials. The purpose of this study was to examine the microhardness of the materials after setting in moist or dry conditions. Methods: A simulated open apex and periapical environment model was created using polyethylene tubes placed into a porous block filled with phosphate-buffered saline. White ProRoot Mineral Trioxide Aggregate (MTA; Dentsply Tulsa Dental, Tulsa, OK), EndoSequence Root Repair Material (ESRRM; Brasseler USA, Savannah, GA), and Biodentine (BD; Septodont, Louisville, CO) were mixed and placed into the apical 4 mm of the tubes (N = 15). The moist group had a damp cotton pellet above the test materials (mineral trioxide aggregate or ESSRM) with Fuji II LC (GC America, Alsip, IL) sealing the coronal segment. The dry group had gutta-percha placed directly against the test materials with amalgam sealing the coronal segment. After 10 days of storage in 100% humidity at 37°C, samples were sectioned, and microhardness was independently measured at 2 mm and 4 mm from the apical end. Differences were assessed using analysis of variance and a Tukey post hoc test (α = .05). Results: Analysis of variance analyses showed no significant effect of wet or dry conditions on resultant material hardness. A Tukey post hoc test showed that using ESRRM and BD would not result in a significant difference in hardness, but using MTA would result in statistically significant different hardness values when compared with ESRRM or BD. Conclusions: Either a moist or dry environment could allow hardening of materials; thus, both methods could be acceptable for clinical treatment procedures. [Copyright &y& Elsevier]