Physico-Chemical Properties of Calcium-Silicate vs. Resin Based Sealers—A Systematic Review and Meta-Analysis of Laboratory-Based Studies
Abstract
:1. Introduction
2. Materials and Methods
Literature Research
3. Literature Screening and Study Selection
4. Data Extraction
Quality Assessment and Risk of Bias Analysis
5. Results
5.1. Physico-Chemical Properties and Meta-Analysis
5.1.1. Marginal Adaptation
5.1.2. Fracture Resistance
5.1.3. Pushout Bond Strength
5.1.4. Penetration Depth
5.1.5. Apical Microleakage
5.1.6. Coronal Discoloration
5.1.7. Bacterial Leakage
6. Discussion
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement.
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Search Strategy | |
---|---|
Focused Question | Is there a difference between calcium silicate based sealers and resin-based sealers in terms of physico-chemical properties on the outcome of root canal treatment using a single cone obturation technique for extracted permanent teeth? |
PICO Strategy | |
Population | (Permanent Dentition [MeSH] OR Adult Dentition OR Secondary Dentition OR Permanent teeth OR Teeth OR Extracted teeth OR Root Canal Obturation [MeSH] OR Single cone obturation |
Intervention (#1) | (Bioceramic sealer OR Endosquence BC OR iRoot Plus OR MTA fillapex OR Totalfill BC OR tricalcium phosphate OR tricalcium phosphate ceramic sealer OR Calcium silicate sealer OR Calcium phosphate sealer OR Endodontic sealer OR Root canal sealer |
Comparisons (#2) | (Epoxy resin-based root canal sealer OR AH Plus OR AH 26 |
Outcomes (#3) | (Depth of penetration OR Adaptability OR Void volume OR Seal ability OR Adhesiveness OR Tooth discoloration OR Fracture resistance OR Fracture strength OR Bond strength OR Push-out bond strength OR Root fracture OR Anti-microbial OR Penetration |
Study design (#4) | (In Vitro Techniques [MeSH] OR In vitro studies OR In vitro studies OR Ex vivo studies |
Search Combination | #1 AND #2 AND #3 AND #4 |
Database Search | |
Language | No restriction (Articles in English language or other language where English translation is possible.) |
Electronic Databases | PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science |
Journals | Journal of Endodontics, International Endodontic Journal, Australian Endodontic Journal, Clinical Oral Investigations, Journal of Conservative Dentistry, Journal of American Dental Association. Brazilian dental journal, Journal of physics, Materials, Dental materials etc. |
Period of Publication | 1 January 2011 to 31 August 2020 |
Sr. No | Study Id | Sample Size Calculation | Samples with Similar Dimensions | Teeth Randomization | Standardization of Instrumentation Procedures | Standardization of Filling Procedures | Endodontic Treatment Performed by a Single Operator | Blinding of the Observer | Statistical Analysis Carried Out | Risk of Bias |
---|---|---|---|---|---|---|---|---|---|---|
1. | Kim J et al. (2020) [30] | No | Yes | Yes | Yes | Yes | No | No | Yes | Medium risk |
2. | Patri G et al. (2020) [31] | No | Yes | Yes | Yes | Yes | No | Yes | Yes | Medium risk |
3. | Al-Hiyasat et al. (2019) [13] | No | Yes | Yes | Yes | Yes | No | No | Yes | Medium risk |
4. | Al-Kadhi AM et al. (2019) [32] | No | Yes | Yes | Yes | Yes | No | No | Yes | Medium risk |
5. | Alotaibi RM et al. (2019) [33] | No | Yes | Yes | Yes | Yes | Yes | No | Yes | Medium risk |
6. | Eid BM et al. (2019) [34] | No | Yes | Yes | Yes | Yes | No | No | Yes | Medium risk |
7. | El Hachem R et al. (2019) [35] | No | Yes | Yes | Yes | Yes | Yes | No | Yes | Medium risk |
8. | Ozyurek E et al. (2019) [36] | No | Yes | Yes | Yes | Yes | Yes | No | Yes | Medium risk |
9. | Yusufoglu S et al. (2019) [37] | No | Yes | Yes | Yes | Yes | Yes | No | Yes | Medium risk |
10. | Donnermeyer D et al. (2018) [38] | Yes | Yes | Yes | Yes | Yes | No | No | Yes | Medium risk |
11. | Eltair M et al. (2018) [39] | No | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Low risk |
12. | El Sayed et al. (2018) [40] | No | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Low risk |
13. | Germain S et al. (2018) [41] | No | Yes | Yes | Yes | Yes | No | No | Yes | Medium risk |
14. | Huang Y et al. (2018) [42] | No | Yes | Yes | Yes | Yes | No | No | Yes | Medium risk |
15. | Salem AS et al. (2018) [43] | Yes | Yes | Yes | Yes | Yes | No | No | Yes | Medium risk |
16. | Türker ST et al. (2018) [44] | No | Yes | Yes | Yes | Yes | No | No | Yes | Medium risk |
17. | Yanpiset K et al. (2018) [45] | No | Yes | Yes | Yes | Yes | No | No | Yes | Medium risk |
18. | Russell A et al. (2018) [46] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Low risk |
19. | Huang Y et al. (2017) [47] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Low risk |
20. | Remy V et al. (2017) [48] | Yes | Yes | No | Yes | Yes | No | No | Yes | Medium risk |
21. | Yap WY et al. (2017) [49] | Yes | Yes | Yes | Yes | Yes | No | No | Yes | Medium risk |
22. | Ahuja L et al. (2016) [50] | No | Yes | Yes | Yes | Yes | No | No | Yes | Medium risk |
23. | Celikten B et al. (2016) [51] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Low risk |
24. | Madhuri GV et al. (2016) [52] | No | Yes | No | Yes | Yes | No | No | Yes | Medium risk |
25. | Polineni S et al. (2016) [53] | No | Yes | Yes | Yes | Yes | No | Yes | Yes | Medium risk |
26. | Hegde V et al. (2015) [54] | No | Yes | Yes | Yes | Yes | No | No | Yes | Medium risk |
27. | Shinde A et al. (2014) [55] | No | Yes | Yes | Yes | Yes | No | No | Yes | Medium risk |
28. | Topcuoglu HS et al. (2013) [56] | No | Yes | Yes | Yes | Yes | No | No | Yes | Medium risk |
Property | Author, Year | Method | Material | Author’s Conclusion |
---|---|---|---|---|
Adaptation to root canal wall | Kim J. et al. (2020) | Void percentage | EndosealMTA AH Plus Jet | Endoseal MTA does not seem to reduce the voids over time when it was used with a single gutta-percha cone technique. |
Patri G. (2020) | Sealing potential and marginal adaptation | EndoSequence BC ProRoot MTA EndoREZ | Significant and better sealing ability and marginal adaptation was demonstrated by EndoSequence BC (bioceramic sealer) when compared to ProRoot MTA sealer (MTA-based sealer) and EndoREZ sealer (resin-based sealer). | |
Eltair M. et al. (2018) | Areas and interfacial gaps between sealer and dentine | TotalFill BC AH Plus | All tested root canal fillings exhibited minor interfacial gaps. The BC sealer showed better adaptability than the AH Plus sealer. | |
Germain S. et al. (2018) | Voids volume in the apical third | TotalFill bioceramic (NB) sealers AHPlus | Bioceramic (BC) sealers showed good all-round performance demonstrating good adaptability, and reduced voids while maintaining similar characteristics when compared with conventional resin sealer. | |
Huang Y. et al. (2018) | Total ROI volume (mm3), object volume (dentin volume, mm3), volume of closed pores (mm3), surface of closed pores (mm2), volume of open pores (mm3), and open porosity (%) | EndoSequence BC AHPlus | By using the single cone technique, neither endoSequence or AH Plus provides a porosity-free root canal filling. The EndoSequence BC sealer may have similar sealing abilities regarding the whole root canal as the AH Plus sealer. A better sealing effect could be obtained in the coronal and middle sections of a root canal than the apical part by using the tested sealers. | |
Huang Y. et al. (2017) | Void volume in (mm3) | Sure Seal Root Total BC Sealer AH Plus | A high incidence rate of voids was found within each sealer material and no significant difference was found among the root filling sealers. | |
Remy V. et al. (2017) | Marginal adaptation | MTA Fillapex AH Plus | AH Plus sealer shows a good marginal adaptation. | |
Celikten B. et al. (2016) | Voids in 3D volumes | EndoSequence BC AH Plus | All root canal sealers tested resulted in voids. The bioceramic sealers (Endo Sequence BCSealer, Smartpastebio) produced similar voids which had the fewest in the apical third of root canals. | |
Polineni S. et al. (2016) | Maximum gap width (nm) | MTA Fillapex EndoSequence BC MM-Seal | Epoxy resin-based MM-Seal showedgood marginal adaptation than the MTA Fillapex. apical halves showed poor adaptation regardless of the material used than the coronal halves | |
Shinde A. et al. (2014) | Mean distance from the radicular dentin to the root canal fillings was in (mm) | Endo- Sequence BC AH Plus | Endosequence BC endodontic sealers showed better adaptation to the radicular dentin as compared to AH Plus sealer. | |
Fracture Resistance | Ozyurek E. et al. (2019) | Fracture resistance values (FRV) in Newtons | MTA Plus BioRoot RCS AH 26 | Root canal preparation lowered the fracture resistance values. All sealers increased the force values needed to fracture the filled samples compared to unfilled ones but the time factor had no effect on the reinforcement effect of root canal sealers. |
Yusufoglu S. et al. (2019) | Push-out bond strength | BioRoot RCS AH Plus | All the three root canal sealers examined in this study strengthened the prepared root canals with increased fracture resistance | |
Hegde V. et al. (2015) | Forces in Newton | EndoSequence BC AH Plus | Hydrophilic obturations have shown to reinforce the strength of the root canal after instrumentation, and thus increasing the fracture resistance of the root to the stresses encountered | |
Topcuoglu H.S. et al. (2013) | Forces in newtons | EndoSequence BC AH Plus | Endosequence BC sealer and AH Plus Jet were able to increase the force to fracture in single-rooted endodontically treated premolar teeth. | |
Bond strength | Al-Hiyasat et al. (2019) | Push-out bond strength | TotalFill AH plus | Overall the push-out bond strength of TotalFill BC sealer was significantly higher than that of AH plus sealer. |
Eid B.M. et al. (2019) | Push-out bond strength | Totalfill bioceramic Adseal sealer | The push-out bond strength of the tested TotalFill root canal sealer was higher than the pushout bond strength of Adseal resin sealer | |
Donnermeyer D. et al. (2018) | Push-out bond strength | Total Fill BC AH Plus | The push-out bond strength of the investigated calcium silicate-based sealers was lower than of AH Plus. Total Fill BC showed the highest push-out bond strength of the calcium silicate-based sealers. | |
Türker S.T. et al. (2018) | Push-out bond strength | BioRoot RCSMTA Plus AH 26 | Dentinal tubule penetration had limited effect on the push-out bond strength of the root canal sealers. | |
Yap W.Y. et al. (2017) | Push-out bond strength | TotalFill BC AH Plus | TotalFill BC TM sealer (G3) showed comparable bond strengths to AH Plus. The bond strength also exhibited an increase over a 3-month post-obturation period. | |
Madhuri G.V. et al. (2016) | Push-out bond strength | Bioceramic Sealer Epoxy resin-based sealer | Endosequence BC (Bioceramic Sealer) showed the highest push-out bond strength among all the four groups. MM (Epoxy resin based sealer) showed the second highest bond strength followed by Hybrid seal (Dual cure resin based sealer) | |
Penetration depth | El Hachem R. et al. (2019) | Dentinal penetration depth | BC Sealer AH Plus | BC Sealer and NTS demonstrated better dentinal tubule penetration results compared to AH Plus. |
Türker S.T. et al. (2018) | Dentinal penetration depth | BioRoot RCSMTA Plus AH 26 | Dentinal tubule penetration had limited effect on the push-out bond strength of the root canal sealers. | |
Russell A. et al. (2017) | Dentinal penetration depth | MTA Fillapex AH Plus | Coronal sections of roots have superior adaptation and penetration compared with middle sections. Penetration in middle sections was significantly more favourable in teeth without the butterfly effect. | |
Apical Microleakage | Al-Kadhi et al. (2019) | Apical linear dye penetration | Total fill BC Acroseal | No sealer can completely prevent microleakage, but the bioceramic is superior in performance to the other Sealers |
El Sayed et al. (2018) | Apical linear dye penetration | MTA FillapexEndoSequence BC AH Plus | Higher apical leakage values were observed with single-cone gutta-percha/EndoSequence BC as compared gutta-percha/AH Plus, single-cone gutta-percha/MTA Fillapex | |
Salem A.S. et al. (2018) | Apical linear dye penetration | Total fill BC AH Plus | Total Fill BC was equivalent to AH Plus in apical sealing ability when using single cone. | |
Ahuja L. et al. (2016) | Apical linear dye penetration | MTA Fillapex Pro RootMTA Adseal sealer | Adseal sealer was better in providing the apical seal than Proroot MTA and MTA Fillapex | |
Coronal discoloration | Alotaibi R.M. et al. (2019) | Coronal color change | TotalFill AH Plus | All sealers tested result in a measurable and gradual tooth color change. While the bioceramic sealer resulted in a slightly higher color change compared to calcium hydroxide- and resin-based sealers, the difference was not considerable. |
Apical Bacterial leakage | Yanpiset K. et al. (2018) | Bacterial leakage test with E. faecalis | Bioceramic sealer AH Plus | In roundly-prepared canals, the epoxy resin sealer had lower amount of leaked samples as compared to bioceramic sealers using single cone gutta percha for bacterial leakage at 60 days. |
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Chopra, V.; Davis, G.; Baysan, A. Physico-Chemical Properties of Calcium-Silicate vs. Resin Based Sealers—A Systematic Review and Meta-Analysis of Laboratory-Based Studies. Materials 2022, 15, 229. https://doi.org/10.3390/ma15010229
Chopra V, Davis G, Baysan A. Physico-Chemical Properties of Calcium-Silicate vs. Resin Based Sealers—A Systematic Review and Meta-Analysis of Laboratory-Based Studies. Materials. 2022; 15(1):229. https://doi.org/10.3390/ma15010229
Chicago/Turabian StyleChopra, Viresh, Graham Davis, and Aylin Baysan. 2022. "Physico-Chemical Properties of Calcium-Silicate vs. Resin Based Sealers—A Systematic Review and Meta-Analysis of Laboratory-Based Studies" Materials 15, no. 1: 229. https://doi.org/10.3390/ma15010229