• Restorative Dentistry and Endodontics
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• v.46 no.1
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• pp.4.1-4.16
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• 2021

Objectives: This study evaluated the biocompatibility and bioactive potential of NeoMTA Plus mixed as a root canal sealer in comparison with MTA Fillapex. Materials and Methods: Polyethylene tubes filled with NeoMTA Plus (n = 20), MTA Fillapex (n = 20), or nothing (control group, CG; n = 20) were inserted into the connective tissue in the dorsal subcutaneous layer of rats. After 7, 15, 30 and 60 days, the specimens were processed for paraffin embedding. The capsule thickness, collagen content, and number of inflammatory cells (ICs) and interleukin-6 (IL-6) immunolabeled cells were measured. von Kossa-positive structures were evaluated and unstained sections were analyzed under polarized light. Two-way analysis of variance was performed, followed by the post hoc Tukey test (p ≤ 0.05). Results: At 7 days, the capsules around NeoMTA Plus and MTA Fillapex had more ICs and IL-6-immunostained cells than the CG. However, at 60 days, there was no significant difference in the IC number between NeoMTA Plus and the CG (p = 0.1137) or the MTA Fillapex group (p = 0.4062), although a greater number of IL-6-immunostained cells was observed in the MTA Fillapex group (p = 0.0353). From 7 to 60 days, the capsule thickness of the NeoMTA Plus and MTA Fillapex specimens significantly decreased, concomitantly with an increase in the collagen content. The capsules around root canal sealers showed positivity to the von Kossa stain and birefringent structures. Conclusions: The NeoMTA Plus root canal sealer is biocompatible and exhibits bioactive potential.

• 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.

• Restorative Dentistry and Endodontics
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• v.34 no.1
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• pp.61-68
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• 2009

This study was performed to assess the radiopacity of a variety of root canal sealers according to the specification concerning root canal sealers. Ten materials including Tubli-$Seal^{TM}$. Kerr Pulp Canal $Sealer^{TM}$, AH $26^{(R)}$, AH $plus^{(R)}$, AH plus $jet^{TM}$, Ad sea $1^{TM}$. $Sealer^{TM}$, $NOGENOL^{TM}$, ZOB $seal^{TM}$, $Epiphany^{TM}$ and dentin were evaluated in this study. In the first part, densitometric reading of an each step of aluminum step wedge on occlusal film was performed at different voltage and exposure time. In the second part, ten specimens were radiographed simultaneously with an aluminum step wedges on the occlusal films under decided condition. The mean radiographic density values of the materials were transformed into radiopacity expressed equivalent thickness of aluminum (mm Al). The following results were obtained. 1. Among the various conditions, the appropriate voltage and exposure time that meet the requirement density was 60 kVp at 0.2 s 2. All of the materials had greater radiopacity than 3 mm Al requirement of ANSI/ADA specification No. 57 (2000) and ISO No. 6876 (2001) standards. 3. The radiopacity of materials increased as thickness of materials increased. 4. The mm Al value of each specimen at 1mm in thickness has a significant difference in the statistics. It suggests that root canal sealers have a sufficient radiopacity that meet the requirement.

• Restorative Dentistry and Endodontics
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• v.43 no.3
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• pp.30.1-30.12
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• 2018

Objectives: To evaluate sealing ability of root canals obturated with bioceramic-impregnated gutta percha cone (BCC) or gutta percha (GP), with bioceramic sealer (BCS) or AH Plus (AH; Dentsply-Maillefer), in roundly-prepared canals using matched single-cone technique, based on bacterial leakage test, and to analyze obturation quality using micro-computed tomography (CT) analysis. Materials and Methods: Ninety-two distobuccal roots of maxillary molars were prepared using nickel-titanium files to apical size 40/0.06. The roots were divided into 4 groups (n = 20) that were obturated with a master cone and sealer: GP/AH, BCC/AH, GP/BCS, and BCC/BCS. Bacterial leakage model using Enterococcus faecalis was used to evaluate sealing ability for 60-day period. Obturated samples from each group (n = 4) were analyzed using micro-CT. Results: All groups showed bacterial leakage at 20%-45% of samples with mean leakage times of 42-52 days. There were no significant differences in bacterial leakage among the groups. Micro-CT showed minimal gaps and voids in all groups at less than 1%. Conclusions: In roundly-prepared canals, the single cone obturation with BCC/BCS was comparable to GP/AH for bacterial leakage at 60 days.

• The Journal of the Korean dental association
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• v.18 no.9 s.136
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• pp.739-745
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• 1980

The histologic responses of periapical tissues to root canal fillings with Grossman sealer were studied 10 dogs. Root canal fillings were performed on the 20 lower and upper teeth. The animals were sacrificed 1,2,3,4 and 5 weeks after the completion of operation. The following results were based on histopathologic studies; 1) After 1 week, the necrosis of dentin and cementum surrounding root apex was found in the root canal fillings. 2) After 2 weeks, the necrosis of cementum and surrounding alveolar bone were revealed. The resorption of dentin was appeared partially. 3) After 2 weeks, newly formed dentin was appeared surrounding necrotic dentin. 4) After 4-5 weeks, the osteoblastic activity was revealed abundantly surrounding the alveolar bone. 5) Fibrosis was prominantly appeared surrounding over-filled area, and fibrous encapsulation was performed.

• Restorative Dentistry and Endodontics
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• v.23 no.1
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• pp.366-378
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• 1998

Thermocondensation root canal filling technique have been used to fill accessary canals or to obtain homogeneous root caral fillings. But these thermocondensation technique inevitably produce heat in the canal which can be transmitted through the dentin and cementum and consequently damage periodontal ligamental cells and osteoblasts. In this study, System $B^{TM}$(Analytic technology, WA.D.S.A.) was used to evaluate the reaction of periodontal ligament tissue to "Continous Wave condensation technique" introduced by Buchanan, and the transmitted root surface temperature was measured according to measured root thicknesses. 12 Mandibular incisors of two adult dogs were used for the experiment. 6 controls were filled by lateral condensation technique with sealer.3 specimens were apically filled by Continuous Wave technique at $200^{\circ}C$ for 5 seconds and remaining 3 specimens were additionally backfilled using System $B^{TM}$(Analytic technology, WA.D.S.A.) was used to evaluate the reaction of periodontal ligament tissue to "Continous Wave condensation technique" introduced by Buchanan, and the transmitted root surface temperature was measured according to measured root thicknesses. 12 Mandibular incisors of two adult dogs were used for the experiment. 6 controls were filled by lateral condensation technique with sealer.3 specimens were apically filled by Continuous Wave technique at $200^{\circ}C$ for 5 seconds and remaining 3 specimens were additionally backfilled using System $B^{TM}$ at $100^{\circ}C$ for 20 seconds. Six weeks later, the dogs were sacrificed and the teeth stained with Hematoxylin and Eosin for histologic examination. 6 extracted human teeth were used to measure the transmitted temperature. After cutting off the crown, the canals were prepared and divided into 3 groups with root thickness of 1.5mm, 1.0mm, 0.5mm, 2 teeth in each group. Inside each root canal, System $B^{TM}$ was heated as with the temperature for the apically condensed and the back filled group, and the transmitted heat was measured on the external surface of the root. The temperature of System $B^{TM}$ heat spreader at $200^{\circ}C$ and $100^{\circ}C$ was also measured at root temperature. It can be concluded as follows: 1. In the thin area (200-$250{\mu}m$) of the root, root resorption could be seen even with heating at $200^{\circ}C$ for 5 seconds. 2. When the spreader was heated at $200^{\circ}C$ for 5 seconds and additionally at $100^{\circ}C$ for 20 seconds for backfill, all teeth showed root resorption regardless of their root thickness. 3. The transmitted external root surface temperature was higher as the root thickness decreased and as the heating time increased. In the thermocompaction technique using System $B^{TM}$, the spreader should be heated for the minimal time and used only in the apical area. The heated spreader shouldn't inserted to the binding point of the canal and backfilling should be done with other means of minimally heated gutta percha technique.

• Restorative Dentistry and Endodontics
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• v.43 no.1
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• pp.2.1-2.10
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• 2018

Objectives: To determine the effect of size and insertion depth of irrigation needle on the amount of apical extruded debris and the amount of penetration depth of sealer using a confocal laser scanning microscope (CLSM). Materials and Methods: Twenty maxillary premolars were assigned to 2 groups (n = 10), according to the size of needle tip, 28 G or 30 G. Buccal roots of samples were irrigated with respective needle type inserted 1 mm short of the working length (WL), while palatal roots were irrigated with respective needle type inserted 3 mm short of the WL. Prepared teeth were removed from the pre-weighed Eppendorf tubes. Canals were filled with F3 gutta-percha cone and rhodamine B dye-labeled AH 26 sealer. Teeth were transversally sectioned at 1 and 3 mm levels from the apex and observed under a CLSM. Eppendorf tubes were incubated to evaporate the irrigant and were weighed again. The difference between pre- and post-weights was calculated, and statistical evaluation was performed. Results: Inserting needles closer to the apex and using needles with wider diameters were associated with significantly more debris extrusion (p < 0.05). The position of needles and level of sections had statistically significant effects on sealer penetration depth (p < 0.05 for both). Conclusions: Following preparation, inserting narrower needles compatible with the final apical diameter of the prepared root canal at 3 mm short of WL during final irrigation might prevent debris extrusion and improve sealer penetration in the apical third.

• 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.33 no.2
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• pp.133-140
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• 2008

The purpose of this study was to compare the apical micro leakage in root canal filled with Resilon by several self-etching primers and methacrylate-based root canal sealer. Seventy single-rooted human teeth were used in this study. The canals were instrumented by a crown-down manner with Gate-Glidden drills and .04 Taper Profile to ISO #40. The teeth were randomly divided into four experimental groups of 15 teeth each according to root canal filling material and self-etching primers and two control groups (positive and negative) of 5 teeth each as follows: group 1 - gutta percha and $AH26^{(R)}$ sealer: group 2 - Resilon, $RealSeal^{TM}$ primer and $RealSeal^{TM}$ sealer: group 3-Resilon, Clearfil SE $Bond^{(R)}$ primer and $RealSeal^{TM}$ sealer group 4-Resilon, $AdheSe^{(R)}$ primer and $RealSeal^{TM}$ sealer. Apical leakage was measured by a maximum length of linear dye penetration of roots sectioned longitudinally by diamond disk. Statistical analysis was performed using the One-way ANOVA followed by Scheffe's test. There were no statistical differences in the mean apical dye penetration among the groups 2, 3 and 4 of self-etching primers. And group 1, 2 and 3 had also no statistical difference in apical dye penetration. But, there was statistical difference between group 1 and 4 (p < 0.05). The group 1 showed the least dye penetration. According to the results of this study, Resilon with self-etching primer was not sealed root canal better than gutta precha with $AH26^{(R)}$ at sealing root canals. And there was no significant difference in apical leakage among the three self-etching primers.

• Restorative Dentistry and Endodontics
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• v.28 no.4
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• pp.295-302
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• 2003

본 연구에서는 인산 칼슘 근관 봉함재 [Apatite Root Sealer (ARS) Type I, II, III]의 세포독성을 혼합후의 시간 경과에 따라서 다른 4계열의 근관 봉함재 (Pulp Canal Sealer EWT, AH Plus, Sealapex, Ketac Endo)와 비교하여 평가하였다. 근관 봉함재를 혼합한 후 1시간, 8시간, 24시간, 48시간, 1주, 2주,4주의 기간동안 배양액을 이용하여 추출액을 얻었다. L929 쥐섬유아세포를 24시간동안 각 시간군에서 얻은 추출액과 함께 배양한 후 dimethylthiazol diphenyltetrazolium (MTT) assay와 neutral red (NR) assay를 이용하여 세포독성(%)을 평가하였다. 실험 결과 ARS Type I, II, III는 전 시간군에 걸쳐 낮은 세포독성을 보였고 (23.65-0.55%) 특히 경화 초기에 다른 계열의 근관 봉함재보다 유의성 있게 낮은 세포독성을 나타내었다. ARS Type I, II, III간의 세포독성은 각 시간군에서 유의성 있는 차이를 보이지 않았다. AH Plus와 Ketac Endo는 초기에 높은 세포독성을 보였으나 AH Plus는 8시간 이후에, Ketac Endo는 24시간 이후에 독성이 급격히 감소하여 ARS와 유의성 있는 차이를 보이지 않았다. Pulp Canal Sealer EWT와 Sealapex는 4주까지 지속적인 세포독성을 나타내었다. 그리고 MTT assay와 NR assay를 이용하여 얻은 각 근관봉함재의 세포독성은 시간 경과에 따라서 비슷한 변화 양상을 나타내었다. 인산 칼슘 근관 봉함재는 생체적합성이 우수한 재료로써 앞으로 지속적인 개발과 평가가 필요할 것으로 사료된다.