Special Issue "Contemporary Endodontic Materials"

A special issue of Materials (ISSN 1996-1944). This special issue belongs to the section "Biomaterials".

Deadline for manuscript submissions: 31 December 2020.

Special Issue Editor

Prof. Hyeon-Cheol Kim
Website
Guest Editor
Department of Conservative Dentistry, School of Dentistry, Pusan National University, Yangsan, Gyeongsangnamdo, 50612, Korea
Interests: NiTi endodontic instruments; fracture resistance; fatigue analysis; endodontic materials; clinical endodontics

Special Issue Information

Dear Colleagues,

Thanks to contemporary endodontic materials, the efficiency and effectiveness of modern clinical endodontics has advanced remarkably. By using these contemporary materials, the clinical success rate and postoperative prognosis of nonsurgical and surgical root canal treatments has increased substantially and, consequently, the ratio of natural teeth preservation has also.

In the field of endodontics, contemporary materials, including various brands of mineral trioxide aggregates, canal irrigation materials and devices, and nickel–titanium instruments made of different alloys have been studied for their properties and effectiveness. Further studies are needed to collate clinically relevant evidence for recently introduced contemporary endodontic materials.

It is my pleasure to invite you to submit a manuscript for this Special Issue with the topic of “Contemporary Endodontic Materials”. Full papers of original articles, communications, and review articles are all welcome.

Prof. Hyeon-Cheol Kim
Guest Editor

Manuscript Submission Information

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Keywords

  • endodontic material
  • endodontic instrument
  • bioceramic material
  • root canal treatment
  • regenerative endodontics
  • biocompatibility

Published Papers (17 papers)

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Open AccessArticle
Advancement of Mechanical Properties of Nickel-Titanium Rotary Endodontic Instruments by Spring Machining on the File Shaft
Materials 2020, 13(22), 5246; https://doi.org/10.3390/ma13225246 - 20 Nov 2020
Abstract
Nickel-titanium (NiTi) endodontic rotary instruments are used extensively in root canal procedures by both general dentists and specialists. However, their vulnerability to fracture is the major reason for clinicians’ concern regarding their use. The objective of this study was to investigate the potential [...] Read more.
Nickel-titanium (NiTi) endodontic rotary instruments are used extensively in root canal procedures by both general dentists and specialists. However, their vulnerability to fracture is the major reason for clinicians’ concern regarding their use. The objective of this study was to investigate the potential effects of spring machining of the file shaft on the fatigue and torsional resistances of NiTi rotary instruments. Three types of NiTi rotary systems with (S) and without (NS) spring machining were used in this study (n = 15 each): a spring file (SPR; #25/.06, SPR-S, SPR-NS), a ProTaper Next X2 (PTN; #25/variable taper, PTN-S, PTN-NS), and a ProTaper Gold F2 (PTG; #25/variable taper, PTG-S, PTG-NS). Spring machining was adjusted on the 6 mm of each file system’s shaft via a laser cutting process. The number of rotation cycles until fracture (i.e., cyclic fatigue resistance), ultimate torsional strength, the distortion angle, and the toughness of each subgroup were estimated with specially designed devices. The results were analyzed using a paired t-test at a significance level of 95%. NiTi rotary instruments with spring machining exhibited a higher cyclic fatigue resistance than instruments without spring machining. The groups with spring machining exhibited a higher toughness and larger distortion angle than the groups without it (p < 0.05). In conclusion, spring machining on the shank of NiTi instruments may provide a stress-bearing area and attenuate the torsional and cyclic fatigue of NiTi rotary instruments. Full article
(This article belongs to the Special Issue Contemporary Endodontic Materials)
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Open AccessArticle
A Novel Bioactive Endodontic Sealer Containing Surface-Reaction-Type Prereacted Glass-Ionomer Filler Induces Osteoblast Differentiation
Materials 2020, 13(20), 4477; https://doi.org/10.3390/ma13204477 - 09 Oct 2020
Abstract
Surface-reaction-type prereacted glass-ionomer (S-PRG) fillers exhibit bioactive properties by the release of multiple ions. This study examined whether a novel endodontic sealer containing S-PRG fillers (PRG+) has the capacity to induce osteoblast differentiation. Kusa-A1 osteoblastic cells were cultured with extracts of PRG+, PRG− [...] Read more.
Surface-reaction-type prereacted glass-ionomer (S-PRG) fillers exhibit bioactive properties by the release of multiple ions. This study examined whether a novel endodontic sealer containing S-PRG fillers (PRG+) has the capacity to induce osteoblast differentiation. Kusa-A1 osteoblastic cells were cultured with extracts of PRG+, PRG− (an experimental sealer containing S-PRG-free silica fillers), AH Plus (an epoxy-resin-based sealer), and Canals N (a zinc-oxide noneugenol sealer). Cell viability and mineralized nodule formation were determined using WST-8 assay and Alizarin red staining, respectively. Osteoblastic-marker expression was analyzed with RT-qPCR and immunofluorescence. Phosphorylation of extracellular signal-regulated kinase (ERK) and p38 mitogen-activated protein kinase (MAPK) was determined with Western blotting. Extracts of freshly mixed PRG+, PRG−, and AH Plus significantly decreased cell growth, but extracts of the set samples were not significantly cytotoxic. Set PRG+ significantly upregulated mRNAs for alkaline phosphatase and bone sialoprotein (IBSP) compared to set PRG−, and upregulation was blocked by NPS2143, a calcium-sensing receptor antagonist. Set PRG+ significantly accelerated IBSP expression, mineralized nodule formation, and enhanced the phosphorylation of ERK and p38 compared with set PRG−. In conclusion, PRG+ induced the differentiation and mineralization of Kusa-A1 cells via the calcium-sensing receptor-induced activation of ERK and p38 MAPK. Full article
(This article belongs to the Special Issue Contemporary Endodontic Materials)
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Open AccessArticle
Biocompatibility and Bioactivity of Set Direct Pulp Capping Materials on Human Dental Pulp Stem Cells
Materials 2020, 13(18), 3925; https://doi.org/10.3390/ma13183925 - 04 Sep 2020
Abstract
In this study, we assessed the biocompatibility and bioactivity of various pulp capping materials—ProRoot MTA (Dentsply Tulsa Dental Specialties), Biodentine (Septodont), TheraCal LC (Bisco), and Dycal (Dentsply Caulk)—on human dental pulp stem cells (hDPSCs). Experimental disks (diameter, 7 mm; height, 4 mm) were [...] Read more.
In this study, we assessed the biocompatibility and bioactivity of various pulp capping materials—ProRoot MTA (Dentsply Tulsa Dental Specialties), Biodentine (Septodont), TheraCal LC (Bisco), and Dycal (Dentsply Caulk)—on human dental pulp stem cells (hDPSCs). Experimental disks (diameter, 7 mm; height, 4 mm) were stored in a humified incubator at 37 °C for 48 h. Then, the pulp capping materials were tested for cytotoxic effects by methyl-thiazoldiphenyl-tetrazolium and scratch wound healing assays, and for mineralization potential by Alizarin red S (ARS) staining assay and alkaline phosphatase enzyme (ALP) activity. Cell viability and cell migration did not significantly differ between ProRoot MTA, Biodentine, and control (p > 0.05). TheraCal LC exhibited slower cell migration on days 2–4 compared to control (p < 0.05), and Dycal showed no cell migration. ALP activity was highest with Biodentine on days 10 and 14, and was lowered with TheraCal LC and Dycal (p < 0.05). In the ARS assay, hDPSCs grown in ProRoot MTA and TheraCal LC eluates showed significantly increased mineralized nodule formation on day 21 compared to Biodentine, Dycal, and control (p < 0.05). These findings indicate that ProRoot MTA, Biodentine, and TheraCal LC exhibit better biocompatibility and bioactivity than Dycal. Full article
(This article belongs to the Special Issue Contemporary Endodontic Materials)
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Open AccessArticle
Efficacy and Cytotoxicity of Binary Mixtures as Root Canal Filling Solvents
Materials 2020, 13(14), 3237; https://doi.org/10.3390/ma13143237 - 21 Jul 2020
Abstract
Objectives: This study reports the efficacy of two solvent mixtures on the dissolution of gutta-percha and AH Plus sealer, together with the cytotoxicity. Methods: Methyl ethyl ketone (MEK), orange oil, tetrachloroethylene, MEK/tetrachloroethylene (1:1), MEK/orange oil (1:1), and chloroform (control) were tested. Twelve groups [...] Read more.
Objectives: This study reports the efficacy of two solvent mixtures on the dissolution of gutta-percha and AH Plus sealer, together with the cytotoxicity. Methods: Methyl ethyl ketone (MEK), orange oil, tetrachloroethylene, MEK/tetrachloroethylene (1:1), MEK/orange oil (1:1), and chloroform (control) were tested. Twelve groups (n = 15) of standardized stainless-steel molds filled with softened gutta-percha cones and twelve (n = 15) filled with AH Plus were immersed in the corresponding mixture or individual solvent, in an ultrasonic bath, for either 2 or 5 min. The effect of the solvents was assessed qualitatively by a topographical analysis (scanning electron microscopy) and chemical analysis (Fourier transform infrared spectroscopy), and quantitatively by a weight loss and viscoelastic property (dynamic mechanical analysis) evaluation. The cytotoxicity was assessed on MG63 human osteoblastic cells. Results: The mixtures did not show the formation of new compounds. Both presented significantly higher efficacies compared to their individual solvents, suggesting a synergistic effect. Their dissolution efficacy was similar to that of chloroform, showing high cytocompatibility. Conclusions: The proposed strategy, incorporating ultrasound agitation and profiting from the synergy of adequate solvents, might enhance root canal cleanliness allowing a single-step procedure to dissolve gutta-percha and the sealer remnants, while assuring cytocompatibility with the periapical tissues. Full article
(This article belongs to the Special Issue Contemporary Endodontic Materials)
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Open AccessArticle
Ex-Vivo Comparison of Torsional Stress on Nickel–Titanium Instruments Activated by Continuous Rotation or Adaptive Motion
Materials 2020, 13(8), 1900; https://doi.org/10.3390/ma13081900 - 17 Apr 2020
Cited by 1
Abstract
This study aimed to evaluate the effect of adaptive motion applied to conventional nickel-titanium (NiTi) rotary instruments on torsional stress generation during shaping procedure. One hundred and twenty mesio-buccal canals of molars were randomly assigned to two groups according to the kinetics; adaptive [...] Read more.
This study aimed to evaluate the effect of adaptive motion applied to conventional nickel-titanium (NiTi) rotary instruments on torsional stress generation during shaping procedure. One hundred and twenty mesio-buccal canals of molars were randomly assigned to two groups according to the kinetics; adaptive motion (AD) and continuous rotation (CR). Each group was divided into four subgroups (n = 15) according to the NiTi instrument systems: HyFlex EDM, One Curve, Twisted File Adaptive, and ProTaper Next. A glide path was established with PathFile #1, for each file group being used with either of the kinetic movements. During the instrumentation with the designated motion and file system, the generated torque was measured via the control unit and acquisition module. Based on the acquired data, the maximum and total torque were calculated. The data were statistically analyzed using Kruskal–Wallis and Mann–Whitney tests at a significance level of 95%. The maximum and total torque generated by all instruments were significantly reduced by the adaptive motion (p < 0.05). In the CR group, HyFlex EDM generated the highest maximum and total stress. In the AD group, HyFlex EDM showed the highest maximum torsional stress, and One Curve showed the highest total torsional stress (p < 0.05). The TF Adaptive instrument with adaptive movement produced the lowest maximum and total torsional stress (p < 0.05). Under the conditions of this study, the use of adaptive motion would be useful to reduce the torsional stress of instrument and root dentin. The reduction of torsional stress through adaptive motion may enhance the durability of instruments and reduce the potential risk of dentinal cracks. Full article
(This article belongs to the Special Issue Contemporary Endodontic Materials)
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Open AccessArticle
Marginal Leakage of Endodontic Temporary Restorative Materials around Access Cavities Prepared with Pre-Endodontic Composite Build-Up: An In Vitro Study
Materials 2020, 13(7), 1700; https://doi.org/10.3390/ma13071700 - 05 Apr 2020
Abstract
This study aimed to examine the marginal seal between various commercial temporary restorative materials and exposed dentin/built-up composite. Sixty bovine incisors were cut above the cemento-enamel junction, and half of the dentin was removed to form a step, which was built up using [...] Read more.
This study aimed to examine the marginal seal between various commercial temporary restorative materials and exposed dentin/built-up composite. Sixty bovine incisors were cut above the cemento-enamel junction, and half of the dentin was removed to form a step, which was built up using flowable resin composite. The root canals were irrigated, filled with calcium hydroxide, and sealed using one of six temporary sealing materials (hydraulic temporary restorative material, temporary stopping material, zinc oxide eugenol cement, glass-ionomer cement, auto-cured resin-based temporary restorative material, and light-cured resin-based temporary restorative material) (n = 10 for each material). The samples were thermocycled 500 times and immersed in an aqueous solution of methylene blue. After 2 days, they were cut along the long axis of the tooth and the depth of dye penetration was measured at the dentin side and the built-up composite side. For the margins of the pre-endodontic resin composite build-up, the two resin-based temporary restorative materials showed excellent sealing. Hydraulic temporary restorative material had a moderate sealing effect, but the sealing effect of both zinc oxide eugenol cement and glass-ionomer cement was poorer. Full article
(This article belongs to the Special Issue Contemporary Endodontic Materials)
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Open AccessArticle
Physical Properties, Antimicrobial Activity and In Vivo Tissue Response to Apexit Plus
Materials 2020, 13(5), 1171; https://doi.org/10.3390/ma13051171 - 05 Mar 2020
Abstract
We investigated the physical properties, antimicrobial activity, and tissue reaction to Apexit Plus in comparison to Sealapex. Flow, radiopacity, setting time, and solubility were evaluated in each material. The antimicrobial activity against Enterococcus faecalis was performed. Polyethylene tubes containing Apexit Plus or Sealapex, [...] Read more.
We investigated the physical properties, antimicrobial activity, and tissue reaction to Apexit Plus in comparison to Sealapex. Flow, radiopacity, setting time, and solubility were evaluated in each material. The antimicrobial activity against Enterococcus faecalis was performed. Polyethylene tubes containing Apexit Plus or Sealapex, and without material (control group) were implanted into the subcutaneous tissue of rats. At 7, 15, 30, and 60 days of implantation, the specimens were paraffin-embedded and the number of inflammatory cells (ICs) and the amount of birefringent collagen (BC) were quantified. The von Kossa reaction followed by immunohistochemistry for detection of alkaline phosphatase (ALP) was also performed. Statistical analysis was performed with ANOVA and Tukey test (p ≤ 0.05). The flow value of Apexit Plus was greater than Sealapex, whereas the radiopacity (3.44 mm Al) was lower than Sealapex (6.82 mm Al). Apexit Plus showed lower solubility and shorter initial and final setting (p < 0.0001), whereas the antimicrobial activity was significantly greater than Sealapex. Although the number of ICs was higher in Apexit Plus (p = 0.0009) at 7 days, no significant difference was detected between Apexit Plus and Sealapex at 15, 30, and 60 days. All groups showed higher values for BC in the capsules over time. ALP-immunolabelled cells were observed, mainly around von Kossa-positive structures, either in the capsules of Apexit Plus or Sealapex. Therefore, our results revealed that Apexit Plus exhibited a greater effectiveness against Enterococcus faecalis and better physical properties than Sealapex, except for the radiopacity. In vivo findings indicate that Apexit Plus is biocompatible and presents potential bioactivity in the subcutaneous tissue. Full article
(This article belongs to the Special Issue Contemporary Endodontic Materials)
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Open AccessArticle
The Antibacterial Efficacy and In Vivo Toxicity of Sodium Hypochlorite and Electrolyzed Oxidizing (EO) Water-Based Endodontic Irrigating Solutions
Materials 2020, 13(2), 260; https://doi.org/10.3390/ma13020260 - 07 Jan 2020
Cited by 2
Abstract
The objective of this study was to evaluate the antibacterial efficacy against Enterococcus faecalis and Streptococcus mutans and in vivo toxicity using embryonic zebrafish assays of sodium hypochlorite (NaOCl) and electrolyzed oxidizing (EO) water (containing hypochlorous acid (HOCl))-based root canal irrigating solutions. Methodology: [...] Read more.
The objective of this study was to evaluate the antibacterial efficacy against Enterococcus faecalis and Streptococcus mutans and in vivo toxicity using embryonic zebrafish assays of sodium hypochlorite (NaOCl) and electrolyzed oxidizing (EO) water (containing hypochlorous acid (HOCl))-based root canal irrigating solutions. Methodology: Using 100 μL microbial count of 1 × 108 cfu/mL Enterococcus faecalis to mix with each 10 mL specimen of NaOCl or HOCl for designed time periods. The above protocol was also repeated for Streptococcus mutans. The concentration of viable microorganisms was estimated based on each standardized inoculum using a plate-count method. Zebrafish embryo assays were used to evaluate acute toxicity. Results: All the HOCl or NaOCl treatment groups showed > 99.9% antibacterial efficacy against Enterococcus faecalis and Streptococcus mutans. Zebrafish embryos showed almost complete dissolution in 1.5% NaOCl within 5 min. Both survival rates after being treated with 0.0125% and 0.0250% HOCl for 0.5 min or 1.0 min were similar to that of E3 medium. Conclusions: Both NaOCl and HOCl revealed similar antibacterial efficacy (> 99.9%) against Enterococcus faecalis and Streptococcus mutans. While 1.5% NaOCl fully dissolved the Zebrafish embryos, both 0.0125% and 0.0250% HOCl showed little in vivo toxicity, affirming its potential as an alternative irrigation solution for vital pulp therapy. Full article
(This article belongs to the Special Issue Contemporary Endodontic Materials)
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Open AccessFeature PaperArticle
Biocompatibility and Mineralization Activity of Three Calcium Silicate-Based Root Canal Sealers Compared to Conventional Resin-Based Sealer in Human Dental Pulp Stem Cells
Materials 2019, 12(15), 2482; https://doi.org/10.3390/ma12152482 - 05 Aug 2019
Cited by 7
Abstract
The purpose of this study was to compare the cytotoxic effects and mineralization activity of three calcium silicate-based root canal sealers to those of a conventional resin-based sealer. Experiments were performed using human dental pulp stem cells grown in a monolayer culture. The [...] Read more.
The purpose of this study was to compare the cytotoxic effects and mineralization activity of three calcium silicate-based root canal sealers to those of a conventional resin-based sealer. Experiments were performed using human dental pulp stem cells grown in a monolayer culture. The root canal sealers tested in this study were EndoSequence BC Sealer (Brasseler), BioRoot RCS (Septodont), Endoseal MTA (Maruchi), and AH Plus (Dentsply DeTrey). Experimental disks 6 mm in diameter and 3 mm in height were made and stored in a 100% humidity chamber at 37 °C for 72 h to achieve setting. The cytotoxicity of various root canal sealers was evaluated using a methyl-thiazoldiphenyl-tetrazolium (MTT) assay. To evaluate cell migration ability, a scratch wound healing method was used, and images of the scratch area were taken using a phase-contrast microscope. Cell morphology was evaluated by a scanning electron microscope after direct exposure for 72 h to each sealer disk. In the cell viability assay, there were no significant differences between the EndoSequence BC, BioRoot RCS, Endoseal MTA, and control groups in any experimental period (p > 0.05). In the cell migration assay, there were no significant differences between the EndoSequence BC, Endoseal MTA, and control groups in any experimental period (p > 0.05). BioRoot RCS exhibited slower cell migration relative to EndoSequence BC and Endoseal MTA for up to 72 h (p < 0.05). Conversely, it showed a similar wound healing percentage at 96 h (p > 0.05). In an evaluation of cell morphology, cells in direct contact with EndoSequence BC, BioRoot RCS, and Endoseal MTA disks showed superior spreading compared to those in contact with the AH Plus disk. In an Alizarin red staining assay, EndoSequence BC, BioRoot RCS, and Endoseal MTA showed a significant increase in mineralized nodule formation compared to the AH Plus group (p < 0.05). In conclusion, all calcium silicate-based root canal sealers tested in this study showed good biological properties and mineralization activity compared to conventional resin-based sealer. Full article
(This article belongs to the Special Issue Contemporary Endodontic Materials)
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Open AccessArticle
In Vitro Comparison of Biocompatibility of Calcium Silicate-Based Root Canal Sealers
Materials 2019, 12(15), 2411; https://doi.org/10.3390/ma12152411 - 29 Jul 2019
Cited by 6
Abstract
The aim of this study was to assess the effect of three calcium silicate-based sealers (EndoSeal MTA, Nano-ceramic Sealer, and Wellroot ST) and two epoxy resin-based sealers (AH-Plus, AD Seal) on various aspects, such as cell viability, inflammatory response, and osteogenic potential, of [...] Read more.
The aim of this study was to assess the effect of three calcium silicate-based sealers (EndoSeal MTA, Nano-ceramic Sealer, and Wellroot ST) and two epoxy resin-based sealers (AH-Plus, AD Seal) on various aspects, such as cell viability, inflammatory response, and osteogenic potential, of human periodontal ligament stem cells (hPDLSCs). AH-Plus showed the lowest cell viability on hPDLSCs in all time periods in fresh media. In set media, hPDLSCs showed no significant differences in cell viability among all the tested materials. Wellroot ST showed the highest level of cell adhesion and the morphology of attached cells. AH-plus presented a significantly higher expression of IL-6 and IL-8 than the other sealers. AD Seal and three calcium silicate sealers showed high expression of the mesenchymal stem cell markers. ALP mRNA expression showed a significant increase in time-dependent manner on all of three calcium silicate-based sealers, which do not seem to interfere with the differentiation of hPDLSCs into osteoblasts. Based on the results from this study, calcium silicate-based sealers appear to be more biocompatible and less cytotoxic than epoxy resin-based sealers. Meanwhile, further and long-term clinical follow-up studies are required. Full article
(This article belongs to the Special Issue Contemporary Endodontic Materials)
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Open AccessArticle
Induction of Osteogenic Differentiation of Mesenchymal Stem Cells by Bioceramic Root Repair Material
Materials 2019, 12(14), 2311; https://doi.org/10.3390/ma12142311 - 19 Jul 2019
Cited by 2
Abstract
This study aimed to evaluate the osteogenic activity of Endosequence Root Repair Material (ERRM) putty using rat mesenchymal stem cells (MSCs). The extract of set ERRM and ProRoot-mineral trioxide aggregate (MTA) (control) was cocultured with rat MSCs and incubated for one, three, and [...] Read more.
This study aimed to evaluate the osteogenic activity of Endosequence Root Repair Material (ERRM) putty using rat mesenchymal stem cells (MSCs). The extract of set ERRM and ProRoot-mineral trioxide aggregate (MTA) (control) was cocultured with rat MSCs and incubated for one, three, and seven days. The cell viability and proliferation were assessed. A quantitative real-time polymerase chain reaction for bone morphogenetic protein-2 (BMP-2), alkaline phosphatase, bone sialoprotein, and osteocalcin gene expression was performed. Both materials enhanced cell viability and proliferation, which increased over time. On day seven, the cells treated with either material exhibited significantly greater cell viability compared with control untreated cells. MSCs treated with either material showed deeper alkaline phosphatase staining after three days compared to control untreated cells. Treated MSCs also exhibited upregulation of the gene expression of bone morphogenetic protein-2, alkaline phosphatase, bone sialoprotein, and osteocalcin. Both ERRM and ProRoot-MTA enhance the osteogenic differentiation of MSCs. Full article
(This article belongs to the Special Issue Contemporary Endodontic Materials)
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Open AccessFeature PaperArticle
Porosity Distribution in Apically Perforated Curved Root Canals Filled with Two Different Calcium Silicate Based Materials and Techniques: A Micro-Computed Tomography Study
Materials 2019, 12(11), 1729; https://doi.org/10.3390/ma12111729 - 28 May 2019
Cited by 1
Abstract
The present study evaluated the porosity distribution of BioRoot RCS/single gutta-percha point (BR/SC) and MTA flow (MF) fillings, which were used as plugs for the apical perforation repair in curved canals of extracted mandibular molars using micro-computed tomography (μCT). Forty mesial root canals [...] Read more.
The present study evaluated the porosity distribution of BioRoot RCS/single gutta-percha point (BR/SC) and MTA flow (MF) fillings, which were used as plugs for the apical perforation repair in curved canals of extracted mandibular molars using micro-computed tomography (μCT). Forty mesial root canals of mandibular first molars were shaped with ProTaper NEXT X1–X5 files 2 mm beyond the apex to simulate apical perforations that were randomly divided into two groups (n = 20) according to the material and technique used for the apical plug: BR/SC or MF. The specimens were scanned before and after canal filling at an isotropic resolution of 9.9 μm. The volumetric analysis of voids in the apical 5 mm of the fillings was performed. Data were analyzed using one-way ANOVA with Bonferroni correction (p < 0.05). Micro-computed tomography (µCT) evaluation revealed significant differences between the groups in terms of porosity: the total volume and percentage volume of voids was lower in the BR/SC group in comparison with the MF group (p < 0.05), with the predominance of open pores in both groups. Neither of the materials and/or application techniques were able to produce void-free root fillings in the apical region of artificially perforated curved roots of mandibular molars. Full article
(This article belongs to the Special Issue Contemporary Endodontic Materials)
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Open AccessArticle
Comparison of Screw-In Forces during Movement of Endodontic Files with Different Geometries, Alloys, and Kinetics
Materials 2019, 12(9), 1506; https://doi.org/10.3390/ma12091506 - 08 May 2019
Cited by 3
Abstract
This study compared the maximum screw-in forces of various instruments during their movements. Forty simulated canals in resin blocks were randomly divided into four groups (n = 10): ProTaper Universal F2, ProTaper Gold F2, WaveOne Primary, and WaveOne Gold Primary. To standardize a [...] Read more.
This study compared the maximum screw-in forces of various instruments during their movements. Forty simulated canals in resin blocks were randomly divided into four groups (n = 10): ProTaper Universal F2, ProTaper Gold F2, WaveOne Primary, and WaveOne Gold Primary. To standardize a lumen size, all artificial canals were prepared with ProTaper Universal F1. The rotation speed was set at 350 rpm with an automated 4 mm pecking motion at a speed of 1 mm/s. The pecking depth was increased by 1 mm for each pecking motion until the file reached the working length. During instrumentation, screw-in forces were automatically recorded by customized software. Maximum screw-in forces were analyzed by one-way ANOVA and Tukey’s post hoc comparison with the significance level at 0.05. WaveOne Gold files generated the lowest maximum screw-in forces, followed by ProTaper Gold, WaveOne, and ProTaper Universal (p < 0.05). Under the condition of this study, heat-treated nickel–titanium (NiTi) files with smaller cross-sectional area, fewer contact points, and reciprocating movements resulted in a lower screw-in effect. Full article
(This article belongs to the Special Issue Contemporary Endodontic Materials)
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Open AccessArticle
Effects of Different Calcium Silicate Cements on the Inflammatory Response and Odontogenic Differentiation of Lipopolysaccharide-Stimulated Human Dental Pulp Stem Cells
Materials 2019, 12(8), 1259; https://doi.org/10.3390/ma12081259 - 17 Apr 2019
Cited by 2
Abstract
This study aimed to analyze the effects of different calcium silicate cements (CSCs) on the inflammatory response and odontogenic differentiation of lipopolysaccharide-stimulated human dental pulp stem cells. Human dental pulp stem cells (hDPSCs) were stimulated with lipopolysaccharide (LPS) to induce inflammation. These LPS-induced [...] Read more.
This study aimed to analyze the effects of different calcium silicate cements (CSCs) on the inflammatory response and odontogenic differentiation of lipopolysaccharide-stimulated human dental pulp stem cells. Human dental pulp stem cells (hDPSCs) were stimulated with lipopolysaccharide (LPS) to induce inflammation. These LPS-induced dental pulp stem cells (LDPSCs) were cultured with ProRoot MTA, Biodentine, Retro MTA, and Dycal. Cell viability was evaluated using the Cell Counting Kit-8 assay. Interleukin (IL)-6, IL-8, and transforming growth factor (TGF)-β1 cytokine levels were assessed using the enzyme-linked immunosorbent assay. The expressions of alkaline phosphatase (ALP), osteocalcin, and runt-related transcription factor 2 (RUNX2) were analyzed through real-time polymerase chain reaction. ProRoot MTA, Biodentine, and Retro MTA did not significantly decrease the cell viability of LDPSCs for up to 48 h (p < 0.05). Retro MTA significantly decreased the expression of IL-6 and IL-8 by LDPSCs. ProRoot MTA and Biodentine significantly reduced TGF-β expression by LDPSCs (p < 0.05). Regarding odontogenic differentiation, all CSCs had no effect on ALP expression but increased the production of RUNX2 at 12 h. Full article
(This article belongs to the Special Issue Contemporary Endodontic Materials)
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Open AccessArticle
The Penetration Ability of Calcium Silicate Root Canal Sealers into Dentinal Tubules Compared to Conventional Resin-Based Sealer: A Confocal Laser Scanning Microscopy Study
Materials 2019, 12(3), 531; https://doi.org/10.3390/ma12030531 - 11 Feb 2019
Cited by 4
Abstract
The purpose of this study was to compare the penetration ability of calcium silicate root canal sealers and conventional resin-based sealer using confocal laser scanning microscopy (CLSM). A total of 60 recently extracted single-rooted human premolars were used in this study. The root [...] Read more.
The purpose of this study was to compare the penetration ability of calcium silicate root canal sealers and conventional resin-based sealer using confocal laser scanning microscopy (CLSM). A total of 60 recently extracted single-rooted human premolars were used in this study. The root canals were prepared to a size 40/0.06 taper with ProFile rotary instruments and irrigated with NaOCl and EDTA. After drying all canals, the specimens were randomly divided into three experimental groups (n = 20): Group 1, gutta-percha (GP)/AH Plus with continuous wave compaction; group 2, GP/BioRoot RCS with a single-cone technique; and group 3, GP/Endoseal MTA with a single-cone technique. All experimental samples were sectioned perpendicular to their long axis using a low-speed diamond wheel at the apical, middle, and coronal third levels. The penetration abilities of all samples were evaluated using CLSM. A Kruskal–Wallis analysis and a series of Mann–Whitney U post hoc tests were performed. A higher intensity level was found in the coronal area and a lower intensity level in the apical area in all the experimental groups. The AH Plus group showed higher sum fluorescence intensity in the apical and coronal thirds compared with the BioRoot RCS and Endoseal MTA groups, whereas the BioRoot RCS group showed a higher intensity level in the middle third, similar to the AH Plus group. The maximum sealer penetration depth was low in the apical area and high in the coronal area in the AH Plus and Endoseal MTA groups. In the BioRoot RCS group, maximum sealer penetration was observed in the middle third. In conclusion, there were significant differences in sealer penetration pattern and distance according to the root level and sealer type. Full article
(This article belongs to the Special Issue Contemporary Endodontic Materials)
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Open AccessArticle
Effective Establishment of Glide-Path to Reduce Torsional Stress during Nickel-Titanium Rotary Instrumentation
Materials 2019, 12(3), 493; https://doi.org/10.3390/ma12030493 - 05 Feb 2019
Cited by 2
Abstract
This study compared the torque generation during canal shaping with a nickel-titanium endodontic instrument according to the extent of glide-path establishment. Seventy-five simulated S-shaped canal blocks were divided into five groups (n = 15) according to the number of repetitive insertions to the [...] Read more.
This study compared the torque generation during canal shaping with a nickel-titanium endodontic instrument according to the extent of glide-path establishment. Seventy-five simulated S-shaped canal blocks were divided into five groups (n = 15) according to the number of repetitive insertions to the working length using a One G glide-path instrument: groups with 5, 10, 15, and 20 insertions as well as group Z without glide-path establishment. When the tip of the One G file reached the working length, the file was moved back and forth repetitively at the working length for the designated number of times for each group. The instrumentation procedure with HyFlex EDM had 15 pecking strokes. During instrumentation, the generated torque was transmitted to a customized data acquisition module and collected using customized software. Data were computed to determine the maximum torque and total stress. The maximum screw-in forces were statistically analyzed using one-way analysis of variance and Tukey’s post hoc comparison test with a significance level of 95%. While the maximum stress did not have significant differences among the five groups (p > 0.05), groups with more than 10 repetitive insertions generated lower total stress during instrumentation than did the group with 5 insertions and group Z (p < 0.05). Under the limitations of this study, repetitive insertions of glide-path establishment files at the working length reduced stress generation during the shaping using nickel-titanium instruments. Full article
(This article belongs to the Special Issue Contemporary Endodontic Materials)
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Open AccessFeature PaperReview
Regenerative Endodontic Procedures Using Contemporary Endodontic Materials
Materials 2019, 12(6), 908; https://doi.org/10.3390/ma12060908 - 19 Mar 2019
Cited by 10
Abstract
Calcium hydroxide apexification and Mineral Trioxide Aggregate (MTA) apexification are classical treatments for necrotic immature permanent teeth. The first tend to fail for lack of compliance given the high number of sessions needed; the second has technical difficulties such as material manipulation and [...] Read more.
Calcium hydroxide apexification and Mineral Trioxide Aggregate (MTA) apexification are classical treatments for necrotic immature permanent teeth. The first tend to fail for lack of compliance given the high number of sessions needed; the second has technical difficulties such as material manipulation and overfilling. With both techniques, the root development is interrupted leaving the tooth with a fragile root structure, a poor crown-to-root ratio, periodontal breakdown, and high risk of fracture, compromising long-term prognosis of the tooth. New scientific literature has described a procedure that allows complete root development of these specific teeth. This regenerative endodontic procedure (REP) proposes the use of a combination of antimicrobials and irrigants, no canal walls instrumentation, induced apical bleeding to form a blood clot and a tight seal into the root canal to promote healing. MTA is the most used material to perform this seal, but updated guidelines advise the use of other bioactive endodontic cements that incorporate calcium and silicate in their compositions. They share most of their characteristics with MTA but claim to have fewer drawbacks with regards to manipulation and aesthetics. The purpose of the present article is to review pertinent literature and to describe the clinical procedures protocol with its variations, and their clinical application. Full article
(This article belongs to the Special Issue Contemporary Endodontic Materials)
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