• Restorative Dentistry and Endodontics
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• v.27 no.2
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• pp.207-211
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• 2002

항균 활성도는 Root canal sealer가 갖추어야 할 필수요소 중 하나이다. 본 연구는 최근 임상술식에 사용되고 있는 8종의 root canal sealer의 근관내 혐기성 세균에 대한 항균효과를 알아보기 위해 시행되었다. 또한 본 연구에서는 혼합직후의 경화되지 않은 sealer와 경화 7일 후 sealer의 항균효과도 비교하였다. 항균효과 측정을 위해 사용된 균주는 최근 실패한 근관치료 증례에서 배양되어 보고된 바 있는 Enterococcus faecalis와 근관내 주요 감염균인 그램음성 혐기성세균인 Staphylococcus aureus를 대상으로 하였고, Agar diffusion test 방법을 사용하였다. 실험방법으로는 2개의 paper disk에 신선하게 혼합한 각각의 sealer를 도포하여 한개의 disk는 즉시 실험에 사용하고 다른 한개의 disk는 일주일간 혐기성 배양기에서 경화시킨 다음 사용한다 각각의 균주를 Brucellar blood agar plate에 접종한 다음, sealer가 도포된 paper disk를 plate상에 올려놓는다. 대조군으로는 식염수에 침윤시킨 disc를 같은 방법으로 각 실험단계에 사용한다. 각 plate를 혐기성 배양기에서 48시간동안 배양한 뒤 실험에 사용한 sealer의 항균효과를 6mm paper-disk를 둘러싼 inhibition zone을 측정하여 평가한다. Fisher's PLSD분석방법 결과 E. faecalis에 대하여 경화 전과 후의 AH26모두 경화 전과 후의 Roth 801, Dentalis, Apexit, AH Plus, RSA그리고 경화 후의 MCS보다 유의성 있게 강한 항균효과를 나타내는 것으로 보고되었으며. 경화 후의 AH26은 경화 전의 AH 26, 경화 전의 Ketac Endo, 경화 전의 MCS보다 통계학적으로 유의성이 있는 항균작용을 하는 것이 관찰되었다 (p＜0.05). 경화 후 Roth 801, 경화전과 후의 Dentalis, AH plus, Apexit, RSA는 E. faecalis에 대한 항균효과를 나타내지 못하였다. S. aureus에 대하여 경화후의 AH26이 경화 전과 후의 Roth 801, Apexit, AH Plus, RSA보다 유의성있는 항균효과를 보이는 것을 발견 할 수 있었고, 경화 전의 AH 26이 경화 후의 AH plus보다 나은 항균효과를 나타냄을 알 수 있었다. 또, 경화 전과 후의 Apexit, 경화 후의 AH Plus, 경화 전과 후의 RSA에서는 S. aureus에 대한 항균작용이 발견되지 않았다. 본 실험의 결과 AH26이 가장 강한 항균 작용을 갖는 것을 알 수 있었으며, 각 sealer의 경화 전과 후의 항균효과는 AH26이 경화 전보다 경화 후에서 더 강한 항균효과를 나타내는 것 이외에는 효과의 차이가 없었다.

• Journal of Dental Rehabilitation and Applied Science
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• v.38 no.4
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• pp.213-221
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• 2022

Purpose: The efficacy of the amount of sealer in the root canal and two retreatment NiTi file systems in removing filling materials. Materials and Methods: Extracted premolars with a single root canal were selected for this study. After access opening and root canal preparation up to size #40/.06, the specimens were randomly divided into four groups. Gutta percha (GP) tapers of .06 or .04 were used for each group and filled using a single-cone filling technique with CeraSeal, a calcium silicate-based sealer. Each group was retreated either using the ProTaper Universal Retreatment System (PTUR) or the Hyflex Remover (HR). The time taken to remove the filling material, the amounts of apically extruded debris, and canal cleanliness were measured and compared. Results: The amount of sealer did not affect the efficiency when removing the filling materials. However, the filling material was removed faster in the HR group than in the PTUR group. Two types of NiTi files showed similar retreatment effects in the amounts of apically extruded debris and in the degree of canal cleanliness. Conclusion: The amount of sealer in canal filling had no significant effect on retreatability. Retreatment with HR removed filling materials is faster than PTUR. There was no difference in other removal efficiencies according to the type of retreatment NiTi file.

• Restorative Dentistry and Endodontics
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• v.14 no.2
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• pp.38-48
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• 1989

The purpose of this study was to investigate the proper consistency of root canal sealer needed in obtaining an efficient canal obturation in injection-thermoplasticized low-temperature ($70^{\circ}C$) gutta-percha method. The sealer was made by incorporating zinc oxide powder into $0.5m{\ell}$ of eugenol and then the $0.5m{\ell}$ of mixture slurry was placed between two flat glass plates. The consistency was determined by measuring the degree of spread of the slurry at loading the 120gm of weight from the top plate. The sealer was prepared according to P/L ratio corresponding to the acquired consistency of 65.45mm, 46.80mm, 28.95mm and 22.60mm. The distal roots were obtained by cutting off from 125 extracted human lower molars and the root canals were prepared by using step-back method. The prepared canals were coated with the sealers on their walls and obturated by using the injection-thermoplasticized low-temperature ($70^{\circ}C$) gutta-percha method. All specimens were immersed in 2% methylene blue dye solution for 48 hours at $37^{\circ}C$. Calipers was used to measured the dye penetration into the root canals from apical constrictions. The results were as follows : The canals obturated without sealer showed significantly more leakage than the canals obturated with sealer. Within the consistency from 65.45mm to 22.60mm, the sealer of 65.45mm appeared significantly better than that of 28.95mm and 22.60mm in the canals obturated by injection-thermoplasticized gutta-percha method, and better than that of 46.80mm without statistical significance.

• Restorative Dentistry and Endodontics
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• v.45 no.4
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• pp.42.1-42.9
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• 2020

Objective: This study aimed to examine the physical properties (pH and flow) of 2 novel bioceramic sealers. Materials and Methods: The tested sealers were a calcium hydroxide sealer (Sealapex) and 2 bioceramic sealers (BioRoot RCS and TotalFill BC Sealer). Flow measurements were conducted according to ISO 6876/2012, with a press method of 0.05 mL of sealer. The pH of fresh samples was tested immediately after manipulation, while set samples were stored for 3 times the recommended setting time. The predetermined time intervals ranged from 3 minutes to 24 hours for fresh samples and from 10 minutes to 7 days and 4 weeks for the set samples. Analysis of variance was performed, with p = 0.05 considered indicating significance. Results: The mean flow values were 26.99 mm for BioRoot, 28.19 for Sealapex, and 30.8 mm for TotalFill BC Sealer, satisfying the ISO standard. In the set samples, BioRoot RCS had higher pH values at 24 hours to 1 week after immersion in distilled water. At 2 weeks, both bioceramic sealers had similar pH values, greater than that of Sealapex. In the fresh samples, the bioceramic sealers had significantly higher initial pH values than Sealapex (p < 0.05). At 24 hours post-immersion, all sealers showed an alkaline pH, with the highest pH observed for TotalFill. Conclusions: The TotalFill BC Sealer demonstrated the highest flow. The bioceramic sealers initially presented higher alkaline activity than the polymeric calcium hydroxide sealer. However, at 3 and 4 weeks post-immersion, all sealers had similar pH values.

• Restorative Dentistry and Endodontics
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• v.23 no.2
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• pp.561-574
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• 1998

The purposes of this study were to observe the difference in the root canal wall after hand instrumentation or engine-driven Ni-Ti instrumentation under the scanning electron microscope, and to evaluate the apical leakage provided by continuous wave of canal filling technique with or without root canal sealer and smear layer. Twenty recently extracted human maxillary anterior teeth were instrumented with K-type files or engine-driven Ni-Ti files, Quantec series 2000$^{TM}$ and irrigated with 5.25% NaOCl alone or 15% EDT A and final flush of 5.25% NaOCl. After the instrumentation and flushing, teeth were split in half with a knife and a mallet. They were then examined with a scanning electron microscope Forty-four recently extracted human maxillary anterior teeth were divided into four groups with and without smear layer and then warm vertical canal filling using System-B with or without sealer. The extent of leakage was scored after immersion in India ink for 1 week. The results were as follows: 1. No significant difference of smear layer was observed between K-type file-instrumented group and engine-driven Ni-Ti file-instrumented group. 2. A group without smear layer showed significantly less apical leakage than a group with smear layer when sealer was used for the canal filling (p<0.01). 3. There was no significant difference between a group without sealer and smear layer and a group without sealer and with smear layer (p<0.01). 4. In groups without smear layer, a group with sealer showed significantly less apical leakage than a group without sealer (p<0.01). 5. When root canals were irrigated with NaOCl alone, a group with sealer showed significantly less apical leakage than a group without sealer (p<0.01).

• Restorative Dentistry and Endodontics
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• v.46 no.2
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• pp.27.1-27.10
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• 2021

This study describes 6 cases of endodontic overfilling with successful clinical outcomes during long-term (up to 35 years) radiographic follow-up. Successful endodontic treatment depends on proper shaping, disinfection, and obturation of root canals. Filling materials should completely fill the root canal space without exceeding the anatomical apex. Overfilling may occur when the filling material extrudes into the periapical tissues beyond the apex. The present case series describes 6 root canal treatments in which overfilling of root canal sealer and gutta-percha accidentally occurred. Patients' teeth were periodically checked with periapical radiographs in order to evaluate the outcomes during long-term follow-up. All cases showed healing and progressive resorption of the extruded materials in the periapex. The present cases showed that if a 3-dimensional seal was present at the apical level, overfilling did not negatively affect the long-term outcomes of root canal treatment.

• Restorative Dentistry and Endodontics
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• v.36 no.5
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• pp.385-396
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• 2011

Objectives: This study evaluated the effects of adhesion variables such as the priming concepts of canal wall and the curing modes of adhesives on the sealing ability of a resin-based root canal filling system. Materials and Methods: Apical microleakage of the Resilon-RealSeal systems filled with 3 different combinations of adhesion variables was compared with the conventional gutta-percha filling using a dye penetration method. Experimental groups were SEDC, Resilon (Resilon Research LLC) filling with self-etch RealSeal (SybronEndo) primer and dual-cure RealSeal sealer; NELC, Resilon filling with no etching, Scotchbond Multi-Purpose (3M ESPE) primer application and light-curing adhesive; and TELC, Resilon filling with Scotchbond Multi-Purpose primer and adhesive used under total etch / wet bonding and lightcure protocols. GPCS, gutta-percha filling with conventional AH26 plus sealer, was the control group. Results: The median longitudinal dye penetration length of TELC was significantly shorter than those of GPCS and SEDC (Kruskal-Wallis test, p < 0.05). In the cross-sectional microleakage scores, TELC showed significant differences from other groups at 2 to 5 mm from the apical foramen (Kruskal-Wallis test, p < 0.05). Conclusions: When a resin-based root canal filling material was used, compared to the self-etching primer and the dual-cure sealer, the total etch/wet-bonding with primer and light-curing of adhesive showed improved apical sealing and was highly recommended.

• Restorative Dentistry and Endodontics
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• v.17 no.2
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• pp.263-286
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• 1992

This study was performed to evaluate and compare the cytotoxic effects of five root canal sealers to several different cell lines. Five root canal sealers were AH-26, N2, Sealapex, Tubliseal, and Vitapex. Each sealers were mixed according to the manufacturer's instructions, and culture media were added to each sealers immediately after mixing (the immediate group) and after three days (the third day group) and seven days (the seventh day group) respectively. And every sealer solutions were diluted to 1:1, 1:2, 1:3 and 1:4. Three different permanent cell lines (HEp-2, McCoy, MRC-S) and human gingival fibroblasts and mononuclear cells were challenged by each sealer solution and the cytopathic effects were evaluated using MTT-ELISA, MTT-microscopy, and lactate dehydrogenase (LD) activity. The results were as follows: 1. In HEp-2 and MRC-5 cells, Vitapex was the least cytotoxic sealers. 2. AH-26 showed mild cytotoxic effects to HEp-2, gingival fibroblast and mononuclear cells. 3. N2 was the most toxic sealer to gingival fibroblast and it showed relatively strong cytotoxicity to HEp-2, McCoy and MRC-S cells. 4. Tubliseal showed strong cytotoxic effects to HEp-2, McCoy, MRC-S, and mononuclear cells. 5. Sealapex showed strong cytotoxic effect to HEp-2, McCoy, and gingival fibroblasts.

• Restorative Dentistry and Endodontics
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• v.31 no.1
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• pp.36-49
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• 2006

The purpose of this study was to compare the cytotoxicity by MTT test and genotoxicity by Ames test of new calcium phosphate-based root canal sealers (CAPSEAL I, CAPSEAL II) with commercially available resin-based sealers (AH 26, AH Plus) , zinc oxide eugenol-based sealers (Tubliseal EWT, Pulp Canal Sealer EWT), calcium hydroxide-based sealer (Sealapex), and tricalcium phosphate based sealers (Sankin Apatite Root Canal Sealer I, II, III). According to this study, the results were as follows : 1. The extracts of freshly mixed group showed higher toxicity than those of 24 h set group in MTT assay (p<0.001). 2. CAPSEAL I and CAPSEAL II were less cytotoxic than AH 26, AH Plus, Tubliseal EWT, Pulp Canal Sealer EWT Sealapex and SARCS II in freshly mixed group (p<0.01). 3. AH 26 in freshly mixed group showed mutagenicity to TA98 and TA100 with and without S9 mix and AH Plus extracts also were mutagenic to TA100 with and without S9 mix. 4. Tubliseal EWT, Pulp Canal Sealer EWT and Sealapex in freshly mixed group were mutagenic to TA100 with S9 mix. 5. Among those of 24 h set groups the extracts of SARCS II were mutagenic to TA98 with and without S9 mix and AH 26 showed mutagenic effects to TA98 with S9 mix. 6. No mutagenic effect of CAPSEAL I and CAPSEAL II was detected. 7. There is no statistically significant difference between CAPSEAL I and CAPSEAL II at MTT assay and Ames test in both freshly mixed group and 24 h set group.

• Restorative Dentistry and Endodontics
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• v.41 no.2
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• pp.114-120
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• 2016

Objectives: The aim of this study was to compare the push-out bond strength and dentinal tubule penetration of root canal sealers used with coated core materials and conventional gutta-percha. Materials and Methods: A total of 72 single-rooted human mandibular incisors were instrumented with NiTi rotary files with irrigation of 2.5% NaOCl. The smear layer was removed with 17% ethylenediaminetetraacetic acid (EDTA). Specimens were assigned into four groups according to the obturation system: Group 1, EndoRez (Ultradent Product Inc.); Group 2, Activ GP (Brasseler); Group 3, SmartSeal (DFRP Ltd. Villa Farm); Group 4, AH 26 (Dentsply de Trey)/gutta-percha (GP). For push-out bond strength measurement, two horizontal slices were obtained from each specimen (n = 20). To compare dentinal tubule penetration, remaining 32 roots assigned to 4 groups as above were obturated with 0.1% Rhodamine B labeled sealers. One horizontal slice was obtained from the middle third of each specimen (n = 8) and scanned under confocal laser scanning electron microscope. Tubule penetration area, depth, and percentage were measured. Kruskall-Wallis test was used for statistical analysis. Results: EndoRez showed significantly lower push-out bond strength than the others (p < 0.05). No significant difference was found amongst the groups in terms of percentage of sealer penetration. SmartSeal showed the least penetration than the others (p < 0.05). Conclusions: The bond strength and sealer penetration of resin-and glass ionomer-based sealers used with coated core was not superior to resin-based sealer used with conventional GP. Dentinal tubule penetration has limited effect on bond strength. The use of conventional GP with sealer seems to be sufficient in terms of push-out bond strength.