• Restorative Dentistry and Endodontics
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• v.45 no.3
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• pp.35.1-35.17
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• 2020

Epoxy resin-based sealers are currently widely used, and several studies have considered AH Plus to be the gold-standard sealer. However, it still has limitations, including possible mutagenicity, cytotoxicity, inflammatory response, and hydrophobicity. Drawing upon the advantages of mineral trioxide aggregate, calcium silicate-based sealers were introduced with high levels of biocompatibility and hydrophilicity. Because of the hydrophilic environment in root canals, water resorption and solubility of root canal sealers are important factors contributing to their stability. Sealers displaying lower microleakage and stronger push-out bond strength are also needed to endure the dynamic tooth environment. Although the physical properties of calcium silicate-based sealers meet International Organization for Standardization recommendations, and they have consistently reported to be biocompatible, they have not overcome conventional resin-based sealers in actual practice. Therefore, further studies aiming to improve the physical properties of calcium silicate-based sealers are needed.

• Restorative Dentistry and Endodontics
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• v.48 no.4
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• pp.41.1-41.17
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• 2023

Objectives: This scientometric and bibliometric analysis explored scientific publications related to hydraulic calcium silicate-based (HCSB) sealers used in endodontology, aiming to describe basic bibliometric indicators and analyze current research trends. Materials and Methods: A comprehensive search was conducted in Web of Science and Scopus using specific HCSB sealer and general endodontic-related terms. Basic research parameters were collected, including publication year, authorship, countries, institutions, journals, level of evidence, study design and topic of interest, title terms, author keywords, citation counts, and density. Results: In total, 498 articles published in 136 journals were retrieved for the period 2008-2023. Brazil was the leading country, and the universities of Bologna in Italy and Sao Paolo in Brazil were represented equally as leading institutions. The most frequently occurring keywords were "calcium silicate," "root canal sealer MTA-Fillapex," and "biocompatibility," while title terms such as "calcium," "sealers," "root," "canal," "silicate based," and "endodontic" occurred most often. According to the thematic map analysis, "solubility" appeared as a basic theme of concentrated research interest, and "single-cone technique" was identified as an emerging, inadequately developed theme. The co-occurrence analysis revealed 4 major clusters centered on sealers' biological and physicochemical properties, obturation techniques, retreatability, and adhesion. Conclusions: This analysis presents bibliographic features and outlines changing trends in HCSB sealer research. The research output is dominated by basic science articles scrutinizing the biological and specific physicochemical properties of commonly used HCSB sealers. Future research needs to be guided by studies with a high level of evidence that utilize innovative, sophisticated technologies.

• Korean Journal of Dental Materials
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• v.46 no.1
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• pp.1-10
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• 2019

There are several causes of tooth discoloration following root canal treatment. In this study, we evaluated the effects of sealers on tooth discoloration and internal bleaching. Twenty-four teeth were divided into 4 groups: control group, AH plus, Endosequece BC, and MTA fillapex group. Root canal filling was performed using each sealer conventionally and non-vital bleaching was performed with sodium perborate. The L, a, and b values were measured using Vita easyshade. Tooth discoloration after root canal treatment occurs irrespective of the type of sealers and may cause discoloration with only gutta-percha cone. The effect of non-vital bleaching following the use of calcium silicate-based sealers such as Endosequece BC and MTA fillapex was higher than that of AH plus. Therefore, it needs careful use of sealers in endodontics and calcium silicate-based sealers have advantages of bleaching in case of discolored tooth.

• Journal of dental hygiene science
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• v.21 no.4
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• pp.243-250
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• 2021

Background: Endodontic sealers or their toxic components may become inflamed and lead to delayed wound healing when in direct contact with periapical tissues over an extended period. Moreover, an overfilled sealer can directly interact with adjacent tissues and may cause immediate necrosis or further resorption. Therefore, the treatment outcome conceivably depends on the endodontic sealer's biocompatibility and osteogenic potential. This study aimed to evaluate the cell viability and osteogenic effects of four different sealers in osteoblastic cells. Methods: AH Plus (resin-based sealer), Pulp Canal Sealer EWT (zinc oxide-eugenol sealer), BioRoot RCS (calcium silicate-based sealer), and Well-Root ST (MTA-based calcium silicate sealer) were mixed strictly according to the manufacturer's instructions, and dilutions of sealer extracts (1/2, 1/5 and 1/10) were determined. Cell viability was measured using the water-soluble tetrazolium-8 (WST-8) assay. Differentiation was assessed by alkaline phosphatase (ALP) activity and mineralized nodule formation by Alizarin Red S staining. Results: The cell viability of the extracts derived from the sealers excluding Well-Root ST was concentration dependent, with sealer extracts having the least viability at a 1/2 dilution. At sealer extract dilution of 1/10, the test groups showed the same survival rate as that control group, with the exception of BioRoot RCS. Among all experimental groups, BioRoot RCS showed the highest cell viability after 48 hours. The ALP activity was significantly higher in a concentration-dependent manner. Furthemore, all four materials promoted ALP activity and mineralized nodule formation compared to the control at 1/10 dilutions. Conclusion: This is the first study to highlight the differences in biological activity of these four materials. These results suggest that the composition of root canal sealers appears to alter the form of biocompatibility and osteoblastic differentiation.

• Journal of Dental Rehabilitation and Applied Science
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• v.40 no.1
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• pp.1-12
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• 2024

Purpose: To histologically evaluate the effects of three calcium silicate-based sealers on rat mandible tissue. Materials and Methods: Rats were randomly divided as follows: A group that sacrificed immediately after cavity preparation, a group that sacrificed two weeks after cavity preparation, a group that sacrificed two weeks after CeraSeal (CS), AH Plus Bioceramic (AHB), or One-Fil (OF) sealer injection, respectively. After tissue processing for all groups, the bone tissue area (%) and the number of osteoclasts in and around the cavity were measured under a microscope. The results of each group were compared and statistical analysis was performed using one-way ANOVA and Tukey's test. Results: The formation of bone tissue and the presence of osteoclasts in the cavity were observed in the group that sacrificed two weeks after cavity preparation and the group sacrificed two weeks after AHB sealer injection, and these groups showed significantly higher average bone tissue area (%) than the other groups. In the other groups, no inflammation or foreign body reaction occurred in the cavity, and no osteoclasts were observed. Conclusion: All calcium silicate-based sealers used in this study showed a favorable bone tissue response when injected into the rat mandible. In particular, higher bone formation in the cavity was observed in AHB.

• Journal of Korean Dental Science
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• v.7 no.1
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• pp.1-5
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• 2014

Purpose: Capseal I and Capseal II are calcium silicate and calcium phosphate based experimental root canal sealers. This study sought to evaluate the biocompatibility and mineralization potential of Capseal I and Capseal II. Materials and Methods: The biocompatibility and mineralization related gene expression (alkaline phosphatase [ALP], bone sialoprotein [BSP], and osteocalcin) of Capseal I and Capseal II were compared using methylthiazol tetrazolium assay and reverse transcription-polymerization chain reaction analysis, respectively. The results were analyzed by Kruskal-Wallis test. A P-value of <0.05 was considered significant. Result: Both Capseal I and Capseal II were favorable in terms of biocompatibility, influencing the messenger RNA expression of ALP and BSP. Conclusion: Within the limitation of this study, Capseal is biocompatible, with mineralization promoting potential; thus, it could be a promising root canal sealer.

• Restorative Dentistry and Endodontics
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• v.45 no.3
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• pp.34.1-34.7
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• 2020

Objectives: This study evaluated by using micro-computed tomography (micro-CT) the filling ability and sealer apical extrusion promoted by a new Sealer Injection System (SIS; Angelus) with side openings needle, in comparison with the conventional injection system, associated with a new ready-to-use calcium silicate-based sealer (Bio-C Sealer). Materials and Methods: Acrylic resin models containing a main curved artificial canal and 3 simulated lateral canals in apical, middle and cervical thirds were used. The main root canals were prepared using a rotary system up to size 35.05. The canals were filled with Bio-C sealer by using a single cone technique and the conventional delivery system or SIS. Samples were scanned in micro-CT. The percentage of voids throughout the entire extension of the main root canal and in each third of the lateral canals, besides the apical extrusion of the sealer was calculated. Data were submitted to t-test (p < 0.05). Results: There was no difference between both systems in the main root canals filling. Although the volume percentage of voids was similar in the apical and middle thirds of lateral canals, SIS had the greatest filling ability of the cervical third lateral canal. Moreover, the conventional system showed the highest apical extrusion of the sealer. Conclusions: The conventional and SIS obturation systems had an appropriate filling ability of the main root canal. SIS had the best filling of the cervical third of the lateral canals, besides lower sealer apical extrusion, suggesting its clinical indication.