The Effect of Final Irrigation Protocols on the Apical Sealing Ability of Epoxy Resin-based and Bioceramic-based Root Canal Sealers
DOI:
https://doi.org/10.3889/oamjms.2022.10864Keywords:
Bioceramic, AH plus, Chitosan nanoparticles, EDTA, Sealing abilityAbstract
Aim: This study was designed to investigate the effect of different final irrigation protocols on the apical sealing ability of bioceramic and epoxy resin-based sealers.
Materials and methods: Thirty human single-rooted mandibular premolars were instrumented using ProTaper Next rotary files. Teeth were randomly divided into three groups according to the final irrigation regimen; Group I: 5 ml 0.2% CNPs/3 min, Group II: 2.5 ml 0.2% CNPs/1.5 min followed by 2.5 ml 17% EDTA/1.5 min, and Group III: 5 ml 17% EDTA/3min. All groups were subdivided into two subgroups based on the obturation material; Subgroup A: gutta-percha/Sure-Seal Root BC Sealer and Subgroup B: gutta-percha/AH Plus. All canals were obturated using single cone obturation technique. The apical sealing ability was assessed using modified silver staining technique with ammoniacal silver nitrate tracer solution. Samples were sectioned longitudinally and examined using scanning electron microscope.
Results: Sure-Seal Root BC sealer showed significantly lower nanoleakage compared to AH Plus (p < 0.001). No significant difference was recorded in the nanoleakage of Sure-Seal Root BC sealer among the three groups (p = 0.284), while AH Plus showed a significantly higher nanoleakage in the EDTA group (p = 0.002). The depth of silver nitrate penetration into the dentinal tubules was significantly higher in AH Plus subgroup with the three different irrigation protocols (p < 0.001). For both sealers, the highest penetration depth for silver nitrate tracer solution was recorded in the EDTA group (p < 0.001).
Conclusions: The apical sealing ability of bioceramic sealers is better than that of epoxy resin-based sealers. The type of the final irrigating solution seems to affect the post-obturation seal of both AH Plus and Sure-Seal Root BC sealer.
Keywords: Bioceramic, AH Plus, Chitosan nanoparticles, EDTA, Sealing ability.
Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Mamootil K, Messer HH. Penetration of dentinal tubules by endodontic sealer cements in extracted teeth and in vivo. Int Endod J. 2007;40(11):873-81. https://doi.org/10.1111/j.1365-2591.2007.01307.x PMid:17764458 DOI: https://doi.org/10.1111/j.1365-2591.2007.01307.x
Torabinejad M, Handysides R, Khademi AA, Bakland LK. Clinical implications of the smear layer in endodontics: A review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(6):658-66. https://doi.org/10.1067/moe.2002.128962 PMid:12464887 DOI: https://doi.org/10.1067/moe.2002.128962
Cobankara FK, Adanr N, Belli S. Evaluation of the influence of smear layer on the apical and coronal sealing ability of two sealers. J Endod. 2004;30(6):4069. https://doi.org/10.1097/00004770-200406000-00007 PMid:15167467 DOI: https://doi.org/10.1097/00004770-200406000-00007
Muliyar S, Shameem KA, Thankachan RP, Francis PG, Jayapalan CS, Hafiz KA. Microleakage in endodontics. J Int Oral Health. 2014;6(6):99-104. PMid:25628496
Calt S, Serper A. Time-dependent effects of EDTA on dentin structures. J Endod. 2002;28(1):17-9. https://doi.org/10.1097/00004770-200201000-00004 PMid:11806642 DOI: https://doi.org/10.1097/00004770-200201000-00004
Sinha VR, Singla AK, Wadhawan S, Kaushik R, Kumria R, Bansal K, et al. Chitosan microspheres as a potential carrier for drugs. Int J Pharm. 2004;274(1-2):1-33. https://doi.org/10.1016/j.ijpharm.2003.12.026 PMid:15072779 DOI: https://doi.org/10.1016/j.ijpharm.2003.12.026
No HK, Park NY, Lee SH, Meyers SP. Antibacterial activity of chitosans and chitosan oligomers with different molecular weights. Int J Food Microbiol. 2002;74(1-2):65-72. https://doi.org/10.1016/s0168-1605(01)00717-6 PMid:11929171 DOI: https://doi.org/10.1016/S0168-1605(01)00717-6
Calamari SE, Bojanich MA, Barembaum SR, Berdicevski N, Azcurra AI. Antifungal and post-antifungal effects of chlorhexidine, fluconazole, chitosan and its combinations on Candida albicans. Med Oral Patol Oral Cir Bucal. 2011;16(1):e23-8. https://doi.org/10.4317/medoral.16.e23 PMid:20711160 DOI: https://doi.org/10.4317/medoral.16.e23
Mathew SP, Pai VS, Usha G, Nadig RR. Comparative evaluation of smear layer removal by chitosan and ethylenediaminetetraacetic acid when used as irrigant and its effect on root dentine: An in vitro atomic force microscopic and energy-dispersive X-ray analysis. J Conserv Dent. 2017;20(4):245-50. https://doi.org/10.4103/JCD.JCD_269_16 PMid:29259361 DOI: https://doi.org/10.4103/JCD.JCD_269_16
Mittal A, Dadu S, Yendrembam B, Abraham A, Singh NS, Garg P. Comparison of new irrigating solutions on smear layer removal and calcium ions chelation from the root canal: An in vitro study. Endodontology. 2018;30:55-61. https://doi.org/10.4103/endo.endo_71_17
Shrestha A, Friedman S, Kishen A. Photodynamically crosslinked and chitosan-incorporated dentin collagen. J Dent Res. 2011;90(11):1346-51. https://doi.org/10.1177/0022034511421928 PMid:21911787 DOI: https://doi.org/10.1177/0022034511421928
Cohen ML. Nanotubes, nanoscience, and nanotechnology. Mater Sci Eng C. 2001;15(1-2):1-11. https://doi.org/10.1016/S0928-4931(01)00221-1 DOI: https://doi.org/10.1016/S0928-4931(01)00221-1
Thomas JB, Peppas N, Sato M, Webster TJ. Nanotechnology and Biomaterials. 1st ed. Boca Raton, Florida: CRC Taylor and Francis; 2006.
Shrestha A, Shi Z, Neoh KG, Kishen A. Nanoparticulates for antibiofilm treatment and effect of aging on its antibacterial activity. J Endod. 2010;36(6):1030-5. https://doi.org/10.1016/j.joen.2010.02.008 PMid:20478460 DOI: https://doi.org/10.1016/j.joen.2010.02.008
Carpio-Perochena AD, Bramante CM, Duarte MA, de Moura MR, Aouada FA, Kishen A. Chelating and antibacterial properties of chitosan nanoparticles on dentin. Restor Dent Endod. 2015;40(3):195-201. https://doi.org/10.5395/rde.2015.40.3.195 PMid:26295022 DOI: https://doi.org/10.5395/rde.2015.40.3.195
Soliman AY, Roshdy NN, Lutfy RA. Assessment of the effect of chitosan nanoparticles on the ultra-structure of dentinal wall: A comparative in vitro study. Acta Sci Dent Sci. 2020;4(4):32-8. https://doi.org/10.31080/ASDS.2020.04.0806 DOI: https://doi.org/10.31080/ASDS.2020.04.0806
Sivakami MS, Gomathi T, Venkatesan J, Jeong HS, Kim SK, Sudha PN. Preparation and characterization of nano chitosan for treatment wastewaters. Int J Bio Macromol. 2013:57:204-12. https://doi.org/10.1016/j.ijbiomac.2013.03.005 PMid:23500442 DOI: https://doi.org/10.1016/j.ijbiomac.2013.03.005
Al-Zaka IM, Atta-Allah A, Al-Gharrawi HA, Mehdi JA. The effect of different root canal irrigants on the sealing ability of bioceramic sealer. Mustansiriya Dent J. 2013;10(1):1-7. https://doi.org/10.32828/mdj.v10i1.177 DOI: https://doi.org/10.32828/mdj.v10i1.177
Tay FR, Pashley DH, Yoshiyama M. Two modes of nanoleakage expression in single-step adhesives. J Dent Res. 2002;81(7):472-6. https://doi.org/10.1177/154405910208100708 PMid:12161459 DOI: https://doi.org/10.1177/154405910208100708
De Almeida WA, Leonardo MR, Filho MT, Silva LA. Evaluation of apical sealing of three endodontic sealers. Int Endod J. 2000;33(1):25-7. https://doi.org/10.1046/j.1365-2591.2000.00247.x PMid:11307470 DOI: https://doi.org/10.1046/j.1365-2591.2000.00247.x
White RR, Goldman M, Lin PS. The influence of the smeared layer upon dentinal tubule penetration by plastic filling materials. J Endod. 1984;10(12):558-62. https://doi.org/10.1016/S0099-2399(84)80100-4 PMid:6440943 DOI: https://doi.org/10.1016/S0099-2399(84)80100-4
Farhad AR, Barekatain B, Koushki AR. The effect of three different root canal irrigant protocols for removing smear layer on the apical microleakage of AH26 sealer. Iran Endod J. 2008;3(3):62-7. PMid:24146672
Cobankara FK, Orucoglu H, Sengun A, Belli S. The quantitative evaluation of apical sealing of four endodontic sealers. J Endod. 2006;32(1):66-8. https://doi.org/10.1016/j.joen.2005.10.019 PMid:16410073 DOI: https://doi.org/10.1016/j.joen.2005.10.019
Camps J, Pashley D. Reliability of the dye penetration studies. J Endod. 2003;29(9):592-4. https://doi.org/10.1097/00004770-200309000-00012 PMid:14503834 DOI: https://doi.org/10.1097/00004770-200309000-00012
Sano H, Takatsu T, Ciucchi B, Horner JA, Matthews WG, Pashley DH. Nanoleakage: Leakage within the hybrid layer. Oper Dent. 1995;20(1):18-25. PMid:8700762
Silva PV, Guedes DF, Pécora JD, da Cruz-Filho AM. Time-dependent effects of chitosan on dentin structures. Braz Dent J. 2012;23(4):357-61. https://doi.org/10.1590/s0103-64402012000400008 PMid:23207849 DOI: https://doi.org/10.1590/S0103-64402012000400008
Geethapriya N, Subbiya A, Padmavathy K, Mahalakshmi K, Vivekanandan P, Sukumaran VG. Effect of chitosanethylenediamine tetraacetic acid on Enterococcus faecalis dentinal biofilm and smear layer removal. J Conserv Dent. 2016;19(5):472-7. https://doi.org/10.4103/0972-0707.190022 DOI: https://doi.org/10.4103/0972-0707.190022
Sousa-Neto MD, Coelho FI, Marchesan MA, Alfredo E, Silva-Sousa YT. Ex vivo study of the adhesion of an epoxy-based sealer to human dentine submitted to irradiation with Er: YAG and Nd: YAG lasers. Int Endod J. 2005;38(12):866-70. https://doi.org/10.1111/j.1365-2591.2005.01027.x PMid:16343112 DOI: https://doi.org/10.1111/j.1365-2591.2005.01027.x
Fisher M, Berzins DW, Bahcall JK. An in vitro comparison of bond strength of various obturation materials to root canal dentin using a push-out test design. J Endod. 2007;33(7):856-8. https://doi.org/10.1016/j.joen.2007.02.011 PMid:17804329 DOI: https://doi.org/10.1016/j.joen.2007.02.011
Zhang S, Yang X, Fan M. Bioaggregate and iRoot BP plus optimize the proliferation and mineralization ability of human dental pulp cells. Int Endod J. 2013;46(10):923-9. https://doi.org/10.1111/iej.12082 PMid:23480297 DOI: https://doi.org/10.1111/iej.12082
Azimi S, Fazlyab M, Sadri D, Saghiri MA, Khosravanifard B, Asgary S. Comparison of pulp response to mineral trioxide aggregate and a bioceramic paste in partial pulpotomy of sound human premolars: A randomized controlled trial. Int Endod J. 2014;47(9):873-81. https://doi.org/10.1111/iej.12231 PMid:24330490 DOI: https://doi.org/10.1111/iej.12231
Carvalho CN, Grazziotin-Soares R, Candeiro GT, Martinez LG, de Souza JP, Oliveira PS, et al. Micro push-out bond strength and bioactivity analysis of a bioceramic root canal sealer. Iran Endod J. 2017;12(3):343-8. https://doi.org/10.22037/iej.v12i3.16091 PMid:28808463
Zhang H, Shen Y, Ruse ND, Haapasalo M. Antibacterial activity of endodontic sealers by modified direct contact test against Enterococcus faecalis. J Endod. 2009;35(7):1051-5. https://doi.org/10.1016/j.joen.2009.04.022 PMid:19567333 DOI: https://doi.org/10.1016/j.joen.2009.04.022
Tay FR, Loushine RJ, Weller RN, Kimbrough WF, Pashley DH, Mak YF, et al. Ultrastructural evaluation of the apical seal in roots filled with a polycaprolactone-based root canal filling material. J Endod. 2005;31(7):514-9. https://doi.org/10.1097/01.don.0000152298.81097.b7 PMid:15980711 DOI: https://doi.org/10.1097/01.don.0000152298.81097.b7
Moura-Netto C, Mello-Moura AC, Palo RM, Prokopowitsch I, Pameijer CH, Marques MM. Adaptation and penetration of resin-based root canal sealers in root canals irradiated with high-intensity lasers. J Biomed Opt. 2015;20(3):038002. https://doi.org/10.1117/1.JBO.20.3.038002 PMid:25782626 DOI: https://doi.org/10.1117/1.JBO.20.3.038002
Hassan RE, Riad MI, Kataia MA. Bond degradation resistance of self adhesive sealer bonded to radicular dentin using an alternative adhesive strategy. Tanta Dent J. 2015;12(2):124-31. https://doi.org/10.1016/j.tdj.2015.04.002 DOI: https://doi.org/10.1016/j.tdj.2015.04.002
Chittoni SB, Martini T, Wagner MH, Da Rosa RA, Cavenago BC, Duarte MA, et al. Back-scattered electron imaging for leakage analysis of four retrofilling materials. Microsc Res Tech. 2012;75(6):796-800. https://doi.org/10.1002/jemt.21128 PMid:22147679 DOI: https://doi.org/10.1002/jemt.21128
Yang H, Guo J, Guo J, Chen H, Somar M, Yue J, et al. Nanoleakage evaluation at adhesive-dentin interfaces by different observation methods. Dent Mater J. 2015;34(5):654-62. https://doi.org/10.4012/dmj.2015-051 PMid:26438989 DOI: https://doi.org/10.4012/dmj.2015-051
Tay FR, Pashley DH, Loushine RJ, Doyle MD, Gillespie WT, Weller RN, et al. Ultrastructure of smear layer-covered intraradicular dentin after irrigation with biopure MTAD. J Endod. 2006;32(3):218-21. https://doi.org/10.1016/j.joen.2005.10.035 PMid:16500230 DOI: https://doi.org/10.1016/j.joen.2005.10.035
Tay FR, Hosoya Y, Loushine RJ, Pashley DH, Weller RN, Low DC. Ultrastructure of intraradicular dentin after irrigation with biopure MTAD. II. The consequence of obturation with an epoxy resin-based sealer. J Endod. 2006;32(5):473-7. https://doi.org/10.1016/j.joen.2005.10.054 PMid:16631852 DOI: https://doi.org/10.1016/j.joen.2005.10.054
Zhou HM, Shen Y, Zheng W, Li L, Zheng YF, Haapasalo M. Physical properties of 5 root canal sealers. J Endod. 2013;39(10):1281-6. https://doi.org/10.1016/j.joen.2013.06.012 PMid:24041392 DOI: https://doi.org/10.1016/j.joen.2013.06.012
Tay FR, Pashley DH. Monoblocks in root canals: A hypothetical or a tangible goal. J Endod. 2007;33(4):391-8. https://doi.org/10.1016/j.joen.2006.10.009 PMid:17368325 DOI: https://doi.org/10.1016/j.joen.2006.10.009
Han L, Okiji T. Bioactivity evaluation of three calcium silicatebased endodontic materials. Int Endod J. 2013;46(9):808-14. https://doi.org/10.1111/iej.12062 PMid:23402321 DOI: https://doi.org/10.1111/iej.12062
Candeiro GT, Correia FC, Duarte MA, Ribeiro-Siqueira DC, Gavini G. Evaluation of radiopacity, pH, release of calcium ions, and flow of a bioceramic root canal sealer. J Endod. 2012;38(6):842-5. https://doi.org/10.1016/j.joen.2012.02.029 PMid:22595123 DOI: https://doi.org/10.1016/j.joen.2012.02.029
El Hachem R, Khalil I, Le Brun G, Pellen F, Le Jeune B, Daou M, et al. Dentinal tubule penetration of AH plus, BC sealer and a novel tricalcium silicate sealer: A confocal laser scanning microscopy study. Clin Oral Investig. 2019;23(4):1871-6. https://doi.org/10.1007/s00784-018-2632-6 PMid:30225679 DOI: https://doi.org/10.1007/s00784-018-2632-6
Asawaworarit W, Pinyosopon T, Kijsamanmith K. Comparison of apical sealing ability of bioceramic sealer and epoxy resinbased sealer using the fluid filtration technique and scanning electron microscopy. J Dent Sci. 2020;15(2):186-92. https://doi.org/10.1016/j.jds.2019.09.010 PMid:32595900 DOI: https://doi.org/10.1016/j.jds.2019.09.010
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2022 Anan Medhat, Angie Ghoneim, Nehal Nabil Roshdy (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
http://creativecommons.org/licenses/by-nc/4.0
