Penetrability of AH plus and MTA fillapex after endodontic treatment and retreatment: A confocal laser scanning microscopy study

The aim of the study was to assess the penetrability of two endodontic sealers (AH Plus and MTA Fillapex) into dentinal tubules, submitted to endodontic treatment and subsequently to endodontic retreatment. Thirty ex vivo incisors were prepared using ProTaper rotary system up to F3 instrument and divided in three groups according to the endodontic sealer used for root canal filling: AH Plus (AHP), MTA Fillapex (MTAF), and control group (CG) without using EDTA previously to the root canal filling. Rhodamine B dye (red) was incorporated to the sealers in order to provide the fluorescence which will enable confocal laser scanning microscopy (CLSM) assessment. All specimens were filled with gutta‐percha cones using the lateral compaction technique. The specimens were submitted to endodontic retreatment using ProTaper Retreatment system, re‐prepared up to F5 instruments and filled with gutta‐percha cones and the same sealer used during endodontic retreatment. Fluorescein dye (green) was incorporated to the sealer in order to distinguish from the first filling. The roots were sectioned 2 mm from the apex and assessed by CLSM. No difference was found between the two experimental groups (P > 0.05). On the other hand, in the control group the sealers were not capable to penetrate into dentinal tubules after endodontic treatment (P > 0.05). In retreatment cases, none of the sealers were able to penetrate into dentin tubules. It can be concluded that sealer penetrability is high during endodontic treatment. However, MTA Fillapex and AH Plus do not penetrate into dentinal tubules after endodontic retreatment. Microsc. Res. Tech. 77:467–471, 2014. © 2014 Wiley Periodicals, Inc.     

Adhesive interface and bond strength of endodontic sealers to root canal dentine after immersion in phosphate‐buffered saline

This study evaluated the bond strength (BS) and the adhesive interface of four endodontic sealers to root canal dentine, before, and after immersion in phosphate buffered saline (PBS) to simulate an in vivo environment. Eighty roots were instrumented using ProTaper rotatory files, under irrigation with 17% EDTA and 1% NaOCl. Posteriorly were divided into four groups (n = 20) according to the sealer used: Endofill, AH Plus, Sealapex, and MTA Fillapex. Each group was divided into two subgroups (n = 10) and stored at 37°C immersed in water for 7 days and in PBS for 60 days. From each subgroup, 1 mm thick sections were obtained. One section of each region (coronal, middle, and apical) was submitted to the push‐out test and failures were observed. Twelve sections of each subgroup (four from each region) were evaluated under SEM. Three‐way ANOVA evaluation for BS showed significant differences between groups and regions (P < 0.0001), but not between subgroups (P > 0.05). AH Plus had significantly higher BS than the others sealers, regardless of the analyzed subgroup (Tukey's test, P < 0.5). The most common failures were adhesive to dentine and cohesive of the sealer. The SEM evaluation (Kruskal–Wallis, Mann–Whitney) showed homogeneous adhesive interface formed and sealer tags in all groups with significant statistical differences with AH Plus, regardless of PBS immersion. AH Plus was superior to the other sealers for both BS and quality of interface formation. Immersion in PBS did not interfere on BS or adhesive interface of the sealers tested. Microsc. Res. Tech. 77:1015–1022, 2014. © 2014 Wiley Periodicals, Inc.     

Evaluation of epoxy resin sealer after three root canal filling techniques by confocal laser scanning microscopy

The aim of this study was to evaluate the penetration of endodontic sealer into the dentin tubules, the integrity of the sealer layer perimeter, and the sealer area at the apical third after different filling techniques by confocal laser scanning microscopy (CLSM). Forty‐five mandibular premolars were mechanically prepared with ProTaper files, until F5 file. Thereafter, they were filled with an epoxy‐resin sealer (AH Plus) mixed with Rhodamine B dye (0.1% proportion) and allocated in three groups: Group 1, single master cone; Group 2, cold lateral compaction; and Group 3, Thermafil. For confocal laser scanning microscopy analysis, the specimens were transversely sectioned at 4 mm from the apex. The images at ×10 and ×40 were analyzed by Imagetool 3.0 software. Significant differences were not found among the three experimental groups according the dentin‐impregnate area by the sealer (P = 0.68) and between the sealer and root canal perimeter (P = 0.18). However, root canal filling techniques were significantly different when apical sealer areas were compared (P = 0.001). Thermafil group showed smaller sealer areas (8.09%) while cold lateral compaction and gutta‐percha master cone showed similar areas (17.37 and 21.18%, respectively). The dentin‐impregnated area was not dependent on the root canal filling technique. Single master cone, cold lateral condensation and Thermafil techniques presented integrity of the sealer perimeter close to 100% and Thermafil resulted in a significantly thinner sealer layer. Microsc. Res. Tech. 75:1277–1280, 2012. © 2012 Wiley Periodicals, Inc.     

Persistence of Epoxy‐Based Sealer Residues in Dentin Treated With Different Chemical Removal Protocols

The presence of residual endodontic sealer in the pulp chamber may cause discoloration of the dental crown and interfere with the adhesion of restorative materials. The aim of this study was to compare the efficacy of different solvents in removing residues of an epoxy resin‐based sealer (AH Plus) from the dentin walls of the pulp chamber, by scanning electron microscopy (SEM). Forty‐four bovine incisor dental crown fragments were treated with 17% EDTA and 2.5% NaOCl. Specimens received a coating of AH Plus and were left undisturbed for 5 min. Then, specimens were divided in four groups (n = 10) and cleaned with one of the following solutions: isopropyl alcohol, 95% ethanol, acetone solution, or amyl acetate solution. Negative controls (n = 2) did not receive AH Plus, while in positive controls (n = 2) the sealer was not removed. AH Plus removal was evaluated by SEM, and a score system was applied. Data were analyzed by Kruskal–Wallis and Dunn tests. None of the solutions tested was able to completely remove AH Plus from the dentin of the pulp chamber. Amyl acetate performed better than 95% ethanol and isopropyl alcohol (p < 0.05), but not better than acetone (p > 0.05) in removing the sealer from dentin. No significant differences were observed between acetone, 95% ethanol, and isopropyl alcohol (p > 0.05). It was concluded that amyl acetate and acetone may be good options for cleaning the pulp chamber after obturation with AH Plus. SCANNING 35:17‐21, 2013. © 2012 Wiley Periodicals, Inc.     

Cytocompatibility,physical properties,and antibiofilm activity of endodontic sealers with amoxicillin

The aim was to evaluate the cytocompatibility of the AH Plus and Sealapex associated with amoxicillin (AA) in a quantity of 10% by total weight of the sealers, the flow and setting time of these sealers with 10%‐0.25% AA and antibiofilm activity of these sealers associated with AA in a concentration that does not alter their physical properties (1%). Cytocompatibility was assessed by MTT, neutral red and cytoskeletal fluorescence assays. Setting time and flow was evaluated using the specifications of ISO 6876/2012. For the antibiofilm evaluation, materials were placed in direct contact with E. faecalis biofilm induced on dentin blocks. The incorporation of AA into the sealers did not diminish the viability of the fibroblasts and did not cause structural changes in the cytoskeletal. The flow of AH Plus + AA at 1.0; 0.5 and 0.25%, and of Sealapex + AA at 5.5; 2.5; 1.0; 0.5 and 0.25% were within the specifications of the ISO 6876. AH Plus, and AH Plus + AA at 1.0; 0.50 and 0.25% presented a setting time of 730, 439, 455, and 474 min., respectively. Sealapex ‐ pure or associated with AA did not set completely. The addition of 1% AA to the sealers did not increase their antibiofilm activity. It was concluded that the incorporation of 10% AA caused no toxic effects on fibroblasts, but harmed the physical properties. The addition of AA in concentration that does not affect the physical properties of the sealers did not increase their antibiofilm activity.     

Dentinal tubule penetration of endodontic sealers after nonthermal plasma treatment: A confocal laser scanning microscopy study

One of the factors affecting the success of endodontic treatment is to fill the root canal system hermetically. The aim of this in vitro study was to evaluate the effect of nonthermal plasma (NP) on dentinal tubule penetration of root canal sealers using confocal laser scanning microscopy. Forty mandibular premolar teeth were selected and the root canals were prepared with large‐Waveone‐Gold rotary‐files. Specimens were divided into four experimental groups according to sealer and NP treatment (n = 10). G1: AH‐Plus (AH) G2: nonthermal plasma application + AH‐Plus(AH‐P) G3: Endosequence‐BC(BC) G4: nonthermal plasma application + Endosequence‐BC(BC‐P). Cold lateral‐condensation technique was used for the obturation of root canals. The roots were sectioned horizontally and the sections were examined under confocal laser scanning microscopy. The maximum tubule penetration and percentage of penetration values were obtained from the microscopy images and were statistically analyzed with repeated measurements‐ANOVA and the Tukey (HSD) test (p < 0.05). The percentages of dentinal tubule penetration of the groups were not statistically different. The maximum tubule penetration of the AH‐P was statistically lower than that of the BC‐P (p < 0.05). Plasma application had no affect on the percentage of dentinal tubule penetration. Under the conditions of this in vitro Endosequence‐BC sealer showed higher maximum tubule penetration values than AH‐Plus after NP treatment. Percentage of dentinal tubule penetration values of experimental groups was similar.     

Effect of ultrasonic activation on dentinal tubule penetration of calcium silicate‐based cements

This study investigated the dentinal tubule penetration of mineral trioxide aggregate (MTA), NeoMTA Plus and Biodentine placed by either manual condensation or ultrasonic activation in simulated open apex model. Standardized divergent open apex models were created using palatal roots of 60 human maxillary molars and divided into six groups according to the used cements and activation methods (n = 10): MTA‐manual condensation, MTA‐ultrasonic activation, NeoMTA Plus‐manual condensation, NeoMTA Plus‐ultrasonic activation, Biodentine‐manual condensation, Biodentine‐ultrasonic activation. For the measurement of penetration, the cements were mixed with 0.1% Rhodamin B and 6‐mm apical portions of each root canal were obturated in an orthograde direction. The roots were embedded into acrylic blocks, and 1‐mm‐thick sections were obtained at 3 mm from the apex. Specimens were mounted onto glass slides and scanned under a confocal laser scanning microscope (CLSM) and stereomicroscope. Dentinal tubule penetration areas, depth and percentage were measured using LSM and ImageJ software. The data were analyzed using two‐way analysis of variance (anova ) with Bonferroni correction (α = 0.05). No correlation was found between stereomicroscope and CLSM analyses (p > .05). CLSM analysis showed no significant differences between MTA, NeoMTA Plus, and Biodentine groups when manual condensation was used (p > .05). Ultrasonic activation did not increase the tubular penetration of MTA, NeoMTA Plus or Biodentine as compared to manual condensation of each material (p > .05). MTA, NeoMTA Plus and Biodentine showed similar tubular penetration when manual condensation was used. Ultrasonic activation of these cements had no effect on tubular penetration of each material as compared to the manual condensation counterparts.     

Clinical microscopic analysis of protaper retreatment system efficacy considering root canal thirds using three endodontic sealers

To evaluate the efficacy of ProTaper Universal rotary retreatment system and the influence of sealer type on the presence of filling debris in the reinstrumented canals viewed in an operative clinical microscope. Forty‐five palatal root canals of first molars were filled with gutta‐percha and one of the following sealers: G1, EndoFill; G2, AH Plus; G3, Sealapex. The canals were then reinstrumented with ProTaper Universal rotary system. Roots were longitudinally sectioned and examined under an operative clinical microscope (10×), and the amount of filling debris on canal walls was analyzed using the AutoCAD 2004 software. A single operator used a specific software tool to outline the canal area and the filling debris area in each third (cervical, middle, and apical), as well as the total canal area. Data were analyzed by Kruskal‐Wallis test and Tukey test at P < 0.05. Sealapex demonstrated significant differences in the average of filling debris area/canal among the 3 thirds. This group revealed that apical third showed more debris than the both cervical and middle third (P < 0.0001). Endofill presented significantly more filling debris than Sealapex in the cervical third (P < 0.05). In the middle (P = 0.12) and apical third (P = 0.10), there were no differences amongst groups. Debris was left in all canal thirds, regardless of the retreatment technique. The greatest differences between techniques and sealers were found in the cervical third. Microsc. Res. Tech. 75:1233–1236, 2012. © 2012 Wiley Periodicals, Inc.     

Analysis of the interface and bond strength of resin-based endodontic cements to root dentin

This study evaluated by scanning electron microscopy the interface between root dentin and resin cements, with or without additional application of a dual-cured one-step self-etching dentin adhesive. In addition, the push-out bond strength of these materials to dentin was evaluated. Root canals of 50 maxillary human canines were subjected to biomechanical preparation and randomly assigned into five groups (n = 10) according to the obturation employed: I. AH Plus/gutta-percha; II. Endo-REZ/gutta-percha; III. Epiphany SE/Resilon; IV. Endo-REZ/gutta-percha + adhesive; and V. Epiphany SE/Resilon + adhesive. After obturation, two cross sections of 1.0 mm of each third of the root were obtained and analyzed by SEM and push-out. Data were analyzed by Kruskal-Wallis, Two-way ANOVA and Tukey's HSD tests (α = 5%). Significant differences occurred between scores for gap parameters and tags; greater tag formation resulted for Epiphany SE (P < 0.05). There were also significant differences between groups for the bond strength. AH Plus (1.24 ± 0.70) showed higher values (P < 0.05) compared to groups II (0,17 ± 0.19), III (0.10 ± 0.06), IV (0.09 ± 0.08), and V (0.06 ± 0.03), which were statistically similar (P > 0.05). There was no significant difference between the root thirds (P > 0.05). It was concluded that the use of a self-etching adhesive system did not improve the adhesion of resin-based sealers to dentin and that AH Plus showed better bond strength when compared to other cements.     

Effect of different irrigation protocols on the radicular dentin interface and bond strength with a metacrylate‐based endodontic sealer

This study assessed the influence of different endodontic chemical substances on the adhesion of the Epiphany SE/Resilon system (with and without resinous solvent) to radicular dentin walls, using the push‐out test and scanning electron microscopy (SEM). Forty‐eight root canals of human canines were prepared biomechanically with ProTaper rotary files (crown‐down technique) and the radicular dentin was treated with either 17% EDTA, 2% chlorhexidine gel (CHX) or 2.5% NaOCl (control). The root canals were filled with Resilon cones and Epiphany SE sealer with and without resinous solvent. Six groups of eight canals each had their roots sectioned transversally to obtain 1‐mm thick slices. Data were subjected to statistical analysis by ANOVA and Tukey's tests. The specimens treated with 17% EDTA (1.59 ± 0.91) presented higher bond strength (P < 0.05) than those treated with 2.5% NaOCl (0.93 ± 0.27) and 2% CHX (0.92 ± 0.22). Significantly higher bond strength (P < 0.05) was observed when the Epiphany SE was prepared with (1.37 ± 0.78) than without (0.92 ± 0.33) solvent. Adhesive failures were predominant in all groups. SEM analysis showed greater homogeneity of the filling mass when the solvent was added to the sealer. Treatment of root canal walls with 17% EDTA, and addition of a resinous solvent to Epiphany SE produced the highest adhesion to radicular dentin. Microsc. Res. Tech. 77:446–452, 2014. © 2014 Wiley Periodicals, Inc.     

Marginal gaps and voids of three root-end filling materials: A microcomputed tomographic study

A root-end filling material is required to fill the root-end cavity without gaps or voids, to prevent root canal reinfection and to provide periapical healing. Thus, this study evaluated the volume of marginal gaps and voids of three root-end filling materials using microcomputed tomography (micro-CT). Thirty maxillary incisors were prepared and filled with gutta-percha and endodontic sealer. The specimens were scanned using micro-CT and distributed into three groups (n = 10): White MTA, MTA Repair HP, and Bio-C Repair. The root tips were resected at 90° to the longitudinal axis and the cavity (3 mm depth) was prepared with an ultrasonic tip. The materials were handled, and the cavities were filled. The specimens were rescanned and the percentual volume of gaps and voids were analyzed. The data were analyzed using Kruskal–Wallis and Dunn tests (p < .05). No statistical difference was found in the percentage of gaps among the tested materials (p > .05). White MTA presented less voids than Bio-C and MTA Repair HP (p < .05). The materials presented a similar percentual volume of gaps and White MTA presented less voids than other tested materials.     

Analysis of adhesive interface in root canals irradiated by Er,Cr:YSGG laser after luting a fiber post

This study evaluated the effect of Er,Cr:YSGG laser on the root canal dentin after luting a fiber post. Twenty‐four bovine teeth roots were prepared using NiTi instruments and filled with Sealer 26 and gutta‐percha. Post spaces were prepared and roots were distributed according to dentin treatment (n = 8): 2.5%NaOCl (group control), Er,Cr:YSGG laser (1.5 W, 20 Hz, 20 s) (group test 1) or 2.5%NaOCl + Er,Cr:YSGG laser (group test 2). Fiber posts were luted using adhesive cement (Rely X U200, 3M) and roots were prepared to confocal laser scanning microscopy (CLSM) and scanning electron microscope (SEM). The morphology of interface, thickness of cement, and the gaps and tags were analyzed. Non‐parametrical data for thickness of cement were submitted to Friedman and Kruskall–Wallis tests (α = 0.05) and parametrical data for gaps to ANOVA (α = 0.05). CLSM of the cement thickness and gaps revealed no significant difference in surface treatment (NaOCl, Er,Cr:YSGG laser and NaOCl + Er,Cr:YSGG laser) (p > .05) and canal thirds (cervical, middle, and apical) (p > 0.05). SEM showed tags and a residual layer of cement adhered to dentin, mainly in laser‐irradiated specimens. The pretreatment of root canal with Er,Cr:YSGG laser previously to luting the fiber post with a self‐adhesive cement did not influence the cement thickness and gaps but affected the dentin interaction.     

Evaluation of the interaction between sodium hypochlorite and several formulations containing chlorhexidine and its effect on the radicular dentin—SEM and push‐out bond strength analysis

The aim of the current study was to evaluate the presence of debris and smear layer after endodontic irrigation with different formulations of 2% chlorhexidine gluconate (CHX) and its effects on the push‐out bond strength of an epoxy‐based sealer on the radicular dentin. One hundred extracted human canines were prepared to F5 instrument and irrigated with 2.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. Fifty teeth were divided into five groups (n = 10), according to the final irrigation protocol with different 2% CHX formulations: G1 (control, no final rinse irrigation), G2 (CHX solution), G3 (CHX gel), G4 (Concepsis), and G5 (CHX Plus). In sequence, the specimens were submitted to scanning electron microscopy (SEM) analysis, in the cervical‐medium and medium‐apical segments, to evaluate the presence of debris and smear layer. The other 50 teeth were treated equally to a SEM study, but with the root canals filled with an epoxy‐based endodontic sealer and submitted to a push‐out bond strength test, in the cervical, middle, and apical thirds. G2, G3, G4, and G5 provided higher precipitation of the debris and smear layer than G1 (P < 0.05), but these groups were similar to each other (P > 0.05), in both segments. The values obtained in the push out test did not differ between groups, independent of the radicular third (P > 0.05). The CHXs formulations caused precipitation of the debris and smear layer on the radicular dentin, but these residues did not interfere in the push‐out bond strength of the epoxy‐based sealer. Microsc. Res. Tech. 77:17–22, 2014. © 2013 Wiley Periodicals, Inc.     

Persistence of endodontic methacrylate-based cement residues on dentin adhesive surface treated with different chemical removal protocols

The aim of this study was to evaluate the persistence of methacrylate‐based cement residues on the dentin, after dentin surface cleaning with ethanol or acetone, with or without previous application of a dentin adhesive. Forty bovine crown fragments were obtained and the dentin surface was washed with 1.0 mL of 2.5% sodium hypochlorite (NaOCl), followed by 0.1 mL of 17% ethylenediaminetetraacetic acid application for 3 min, and final irrigation with 2.5% NaOCl. The specimens were air dried and resin‐based cement was rubbed onto the dentine surface with a microbrush applicator. In 20 specimens, previously to cement, a dentin adhesive was applied in all surfaces. After 15 min, the surface was scrubbed with a cotton pellet and moistened with ethanol or acetone, compounding the following groups: G1—99.5% ethanol and G2—acetone, without previous use of dentin adhesive; G3—99.5% ethanol and G4—acetone, with previous use of dentin adhesive. The dentin surface was scrubbed until the cement residues could not be visually detected. Sections were then processed for scanning electron microscopy and evaluated at 500× magnification and scores were attributed to each image according to the area covered by residual sealer, and data were subjected to Kruskal–Wallis at 5% significance. The lower residue presence was observed in G3 (P = 0.005). All surface presented cement residues when acetone was used as cleaning solution (P = 0.0005). The cleaning solutions were unable to completely remove the cement residues from both surfaces. The ethanol used after previous application of the dentin adhesive promoted the lower presence of residues. Microsc. Res. Tech. 2012. © 2012 Wiley Periodicals, Inc.     

Enamel erosion and prevention efficacy characterized by confocal laser scanning microscope

The aim of this study was to evaluate the erosion‐inhibiting effect of two toothpastes on the development of erosion‐like lesions, by a confocal laser scanning microscope (CLSM). Forty human enamel blocks were divided into five groups (n = 8), in accordance to evaluate the GC MI Paste Plus and Oral B with stannous fluoride, applied as slurries and associated with toothbrush. Specimens were submitted to an erosion challenge from citric acid (0.5%, pH = 2.8), for 5 min, six times a day, alternating in artificial saliva immersions. Reference group was not exposed to treatment. Part of specimens (Groups 02 and 03) was exposed twice daily just to slurries, for 2 min, therefore specimens from Groups 04 and 05 were also abraded, for 30 s. The enamel surfaces were morphological characterized using CLSM images, with mineral loss being measured using the resulting 3D images referenced to an un‐challenged portion of the sample. Step values were compared using the one‐way ANOVA test. CLSM was shown to be a viable, noncontact, and simple technique to characterize eroded surfaces. The statistical difference in the step size was significant between the groups (P = 0.001) and using multiple comparisons a statistically significant protective effect of toothpastes was shown when these were applied as slurries. Although groups submitted to tooth brush showed mineral loss similar to reference control group, due to the damages of abrasion associated. Microsc. Res. Tech. 77:439–445, 2014. © 2014 Wiley Periodicals, Inc.     

Tubular dentin sealer penetration after different final irrigation protocols: A confocal laser scanning microscopy study

The aim of this study was to evaluate tubular dentin sealer penetration, comparing different final irrigation protocols using a conventional needle (CONV), EndoActivator system (EAS), EndoVac system (EVS), and ultrasound (PUI). Initially, fifty‐two first maxillary molars with a single canal in the palatal root, without abrupt curvatures, resorptive processes, or previous endodontic treatment were selected for this study. Then, the crowns were sectioned to obtain palatal roots 15 mm in length. The root canals were prepared with the ProTaper Universal System and irrigated with 5% NaOCl. Afterwards, the specimens were divided into four groups (n. 13), according to the final irrigation protocol: CONV, EAS, EVS, and PUI. After filling, slices at 3 mm and 5 mm from the apex were obtained for analysis by confocal laser scanning microscopy. Two‐way comparisons between the groups and the levels were performed with Games Howell's test (p < .05). Tubular dentin sealer penetration was higher at 5 mm compared with 3 mm from the apex (p < .05). The EAS group showed a higher percentage of tubular dentin sealer penetration, compared with the CONV group, at both levels. At 3 mm, there was no statistically significant difference among EAS, EVS, and PUI; however, these groups showed better performance, compared with the CONV group. At 5 mm, there was no statistically significant difference between the EAS and EVS groups, but both showed higher sealer penetration than the PUI group (p < .05). The EAS and EVS groups achieved better degrees of tubular dentin sealer penetration, compared with the other groups.     

Tridimensional quantitative porosity characterization of three set calcium silicate‐based repair cements for endodontic use

The aim of the this study was to quantitatively evaluate in three‐dimensional (3D), the porosity degree of three improved silicate‐based endodontic repair cements (iRoot BP Plus^®, Biodentine^®, and Ceramicrete) compared to a gold‐standard calcium silicate bioactive cement (Pro Root^® MTA). From each tested cement, four samples were prepared by a single operator following the manufacturer's instructions in terms of proportion, time, and mixing method, using cylindrical plastic split‐ring moulds. The moulds were lubricated and the mixed cements were inserted with the aid of a cement spatula. The samples were scanned using a compact micro‐CT device (Skyscan 1174, Bruker micro‐CT, Kontich, Belgium) and the projection images were reconstructed into cross‐sectional slices (NRecon v.1.6.9, Bruker micro‐CT). From the stack of images, 3D models were rendered and the porosity parameters of each tested material were obtained after threshold definition by comparison with standard porosity values of Biodentine^®. No statistically significant differences in the porosity parameters among the different materials were seen. Regarding total porosity, iRoot BP Plus^® showed a higher percentage of total porosity (9.58%), followed by Biodentine^® (7.09%), Pro Root^® MTA (6.63%), and Ceramicrete (5.91%). Regarding closed porosity, Biodentine^® presented a slight increase in these numbers compared to the other sealers. No significant difference in porosity between iRoot BP Plus^®, Biodentine^®, and Ceramicrete were seen. In addition, no significant difference in porosity between the new calcium silicate‐containing repair cements and the gold‐standard MTA were found. Microsc. Res. Tech., 76:1093–1098, 2013. © 2013 Wiley Periodicals, Inc.     

Back-scattered electron imaging for leakage analysis of four retrofilling materials

This study aimed to evaluate, ex vivo, the nanoleakage in dentinal tubules, the linear infiltration of silver nitrate in the dentin wall/root-end filling material interface, and the presence of gaps in this interface in root-end cavities filled with 4 filling materials. Forty-eight disto-buccal root canals of maxillary molars were instrumented and filled. Retrograde cavities were prepared with ultrasonic points (apical 2 mm). The samples were divided into 2 control groups (n = 4) and 4 experimental groups (n = 10): Group I--white mineral trioxide aggregate (MTA); Group II--Super EBA; Group III--Portland cement; and Group IV--Sealer 26. After 1 week, the specimens were subjected to silver nitrate and prepared for SEM (backscattered electrons). In the apical-apical segment, an area with significantly higher leakage was observed for Super EBA, followed by Portland cement, MTA, and Sealer 26 (P = 0.0054). In the medium and cervical segments, all materials showed the same leakage behavior (P = 0.1815 and P = 0.1723, respectively). The linear infiltration at the dentin wall/root-end filling material interface was higher with Super EBA than the other groups. No differences in the percentage of gaps along the 3 mm of dentin wall/root-end filling material interface between the 4 materials were evident (P > 0.05). Nanoleakage occurred mainly in the apical segment of the samples, and Super EBA showed the highest values. The area and linear leakage were lower in the middle and coronal segments, regardless of the root-end filling material. No material perfectly sealed the root-end cavities, which allowed for the leakage occurrence.     

Efficacy of different irrigant protocols and application systems on sealer penetration using a stepwise CLSM analysis

This study compared several irrigation protocols and application systems for sealer penetration into dentinal tubules. Single‐rooted‐human teeth were divided into 5 experimental groups (n = 15) and a control group (n = 5), according to final irrigation protocols: standard needle irrigation (SNI); Vibringe; Vibringe + NaviTip FX (Vibringe NFX); Endo Spray (ES); and passive‐ultrasonic‐irrigation (PUI). Following obturation of the root canals, the percentage of the sealer penetration was measured at different depths using stepwise CLSM analysis. The sealer penetration in the experimental groups was significantly higher than the control group at all levels (p < .05). No significant differences were observed between Vibringe and SNI or Vibringe NFX, ES, and PUI at all depths (p > .05). The Vibringe NFX, ES, and PUI groups allowed deeper sealer penetration than SNI at 100, 250, and 500 μm levels (p < .05). The irrigant activation, the needle design, and the application form (syringe or spray) may impact the quality of the seal that is achieved with root canal filling.     

Evaluation of smear layer removal and marginal adaptation of root canal sealer after final irrigation using ethylenediaminetetraacetic,peracetic, and etidronic acids with different concentrations

The purpose of this study was to investigate the effects of different irrigation solutions on the smear layer removal and marginal adaptation of a resin‐based sealer to root canal dentine. A total of 152 instrumented roots were irrigated with the following irrigants: 9,18% etidronic acid (HEBP), 0.5, 1,2% peracetic acid (PAA), 17% ethylenediaminetetraacetic acid (EDTA), saline. The amount of smear layer was evaluated using scanning electron microscope (SEM) in seventy root samples. Eighty‐two roots were filled with AH Plus and gutta‐percha. Slices obtained from apical third of each specimen were viewed with SEM to assess marginal adaptation. Use of 9% and 18% HEBP resulted in more efficient smear layer removal in the apical third than the other chelators (p < 0.05). Higher smear layer scores in the coronal and middle thirds were obtained from 0.5%, 1% PAA groups. Regarding marginal adaptation, 18% HEBP group showed the lowest gap size values (p < 0.05), and better marginal adaptation. Etidronic acid is a promising candidate for final irrigation of root canals.