• 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.26 no.2
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• pp.141-152
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• 2001

Eliminating the infecting bacteria of the root canal system and preventing reinfection must be the main objectives of all endodontic works. None of commercially available root canal sealers have the properties of desirable tissue compatibility and strong antibacterial activity. The purpose of this study is to develope an ideal root canal sealer using commercially available polyphosphate (polyP), Calgon, which is known to be antibacterial and safe. For the study. resin type AH26, zinc oxide eugenol type Tubli Seal. Ca(OH)$_2$ type Apexit as base sealers for polyP (0~3%) and para formaldehyde containing N2 as a control base were selected. Specimens (3$\times$4mm) of the sealers were prepared in a 37$^{\circ}C$ incubator for 3 and 10 days and their antibacterial activity against streptococci and black pigmented anaerobic rods was observed using an agar diffusion method. The result were as follows: 1. Among 3 day old root canal sealers. N2 as a positive control showed the strongest antibacterial effect. followed by AH26. Tubli Seal and. Apexit which barely showed antibacterial activity against the test bacteria. In contrast. 10 day old AH26 showed a greater antibacterial activity than 10 day old N2. 2. All sealer specimens showed a greater antibacterial activity against black pigmented anaerobic rods than streptococci. Three day old ones appeared to be more antibacterial than 10 day old ones except for Apexit. 3. As compared to N2, 3 day old AH26 demonstrated a similar antibacterial activity against black pig mented anaerobic rods but to a lesser extent to streptococci. Ten day old AH26 showed a greater antibacterial activity against black pigmented anaerobic rods than 10 day old N2. 4. As compared to AH26. Tubli Seal generally revealed a lower antibacterial activity but it showed a greater antibacterial activity aginst S. gordonii Challis. 5. Enhancement of antibacterial activity by polyP was more clearly observed when it was added to Ca(OH)$^{\circ}C$ based root canal sealers. Tubli Seal and N2. 6. The addition of polyP enhanced the antibacterial activity of 3 day old AH26 against S. gordonii G9B (16%) and Challis (29%), and P. gingivalis 2561 (24%) only. Moreover, polyP failed to increase antibacterial activity of 10 day old AH26 against the test strains but P. gingivalis A7A1 28(13%). 7. The addition of polyP increased the antibacterial effect of 3 day old Tubli Seal on several test bacteria including s. mutans GS 5 (50%). s. gordonii G9B (47%) and Challis (122%). and all the test strains of P. gingivalis (13~35%) except for 9 14K 1. The addition of polyP to 10 day old Tubli Seal increased antibacterial activity of the root canal sealer against most test strains. 8. 3 day old Apexit failed to show antibacterial activity. if any very little against S. mutans GS 5 and Pr. intermedia ATCC 49046. However. polyP increased its antibacterial activity by 50 and 69%, respectively. Increase of antibacterial activity of 10 day old Apexit by polyP was more clearly observed than that of 3 day old one.

• 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.45 no.2
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• pp.24.1-24.9
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• 2020

Objectives: It is known that bioactive materials interact with the dentin to undergo biomineralization. The exact role of moisture in this interaction is unknown. Here, we investigate the effects of dentin moisture conditions on the dislocation resistance of two bioactive root canal sealers (MTA Fillapex [Angelus Solucoes Odontologicas] and GuttaFlow BioSeal [Colténe/Whaledent AG]) at 3 weeks and 3 months after obturation. Materials and Methods: Mandibular premolars (n = 120) were prepared and randomly divided into 3 groups based on the dentin condition: group 1, dry dentin; group 2, moist dentin; group 3, wet dentin. Each group was divided into 2 subgroups for root canal filling: MTA Fillapex and GuttaFlow BioSeal. Dislocation resistance was evaluated by measuring the push-out bond strength at 3 weeks and 3 months. Failure modes were examined under a stereomicroscope. Data were statistically analyzed by Kruskal-Wallis test with a significance level of 5%. Results: Moist dentin resulted in higher bond strength values for both materials at both time points. This was significantly higher than wet and dry dentin for both the sealers at the 3 months (p < 0.05), while at 3 weeks it was significant only for GuttaFlow Bioseal. The different moisture conditions demonstrated similar trends in their effects on the dislocation resistance of the 2 root canal sealers. Conclusions: The dentin moisture conditions had a significant impact on its interaction with the bioactive materials tested. Maintaining moist dentin, but not dry or wet dentin, may be advantageous before the filling root canals with bioactive sealers.

• Restorative Dentistry and Endodontics
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• v.16 no.1
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• pp.190-199
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• 1991

The purpose of this study was to evaluate the antimicrobial effect of root canal cements such as AH-26, Sealapex, Canals and Apatite root sealers(Type I, II, III) and to determine the efficacy of their activities. S.mutans(AHT), S.sanguis(NCTC 9811) and B.gingivalis(381) were streaked on blood agar and the PVC tybes filled with root canal cements were applied on. Then the microorganisms were cultured for 48 hours, anaerobically. B.cereus(KCTC 1012) was streaked on nutrient agar, PVC tubes were applied on and were cultured for 48 hours, aerobically. The inhibition zones of root canal cements were measured with vernier caliper. The data statistically analyzed, and the results were as followed. 1. Apatite root sealers(Type I, II, III) showed no inhibition zones. 2. AH-26, Sealapex and Canals had inhibition zones with varying degrees. The inhibition zone of AH-26 was greatest and followed by Canals and Sealapex(P<0.01). 3. As time goes by after mixing the root canal cements, AH-26, Canals and Sealapex showed significantly reducing inhibition zones(P<0.01). 4. There were the least inhibition zones of all the root canal cements on S.mutans and followed in such order as; B.gingivalis, S.sanguis and B.cereus(P<0.01).

• 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.

• Proceedings of the KACD Conference
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• 2001.11a
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• pp.565.2-565
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• 2001

Calcium hydroxide is unavoidably left on the root canal wall when used as an intracanal medicament, and is assumed to have some undesirable influence on the canal sealers. The purpose of this study was to determine whether the $Ca(OH)_2$ change physical properties (Exp. I) and sealing ability (Exp. II) of root canal sealers. Exp. I: As calcium hydroxide agents, $Calcipex^{\circledR}, {\;}Vitapex^{\circledR}, {\;}Calxyl^{\circledR}, {\;}and{\;}Ca(OH)_2$ were used.(omitted)

• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.1
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• pp.95-104
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• 2007

I. Objective The primary requirement of an endodontic root canal sealer is the biologic compatibility, because they remain in close contact with living periapical tissues over a long period of time. The aim of this study was the evaluation of cytotoxicity and genotoxicity of resin-based root canal sealers, AH 26 and ADSEAL. II. Material & Methods In this study, human periodontal ligament cells, human oral cancer cells (KB) and mouse osteoblasts (MC-3T3-E1) were used. Specimens of AH26, ADSEAL were eluted with culture medium for 1, 3, 5 and 7 days. Cytotoxicity was evaluated by using tetrazolium bromide reduction assay (MTT assay) for mitochondrial enzyme activity and cell viability. Genotoxicity was evaluated by using alkaline single cell gel electrophoresis assay (Comet assay). Also cell apoptosis induced by AH 26 was detected by Hoechst33258 staining. III. Results AH 26 and ADSEAL exhibited cytotoxic effects in all investigated cell groups. Genotoxicity was also noted for both sealers in mouse osteoblasts (MC-3T3-E1). But, ADSEAL presented significantly low cytotoxicity and genotoxicity compared with AH 26. Cytotoxicity and genotoxicity induced by AH 26 resulted in apopotosis. IV. Conclusion Our results clearly indicate that the recently invented ADSEAL has better biocompatibility than another resin based root canal sealer, AH 26. However ideal root canal sealer should have not only biocompatibility but also satisfactory physico-chemical properties such as sealing ability and stability. Thus continuous studies and developments should follow.

• Restorative Dentistry and Endodontics
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• v.23 no.2
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• pp.710-717
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• 1998

The pH changes in 3 cavities prepared at the facial inner dentin and lingual outer dentin of the cervical portion and apical portion of roots filled with calcium hydroxide containing sealers were investigated. 50 extracted permanent teeth with single canal were instrumented with step-back method. An irrigant of 5% NaOCl was used between files. Then 3 small cavities were prepared. The cavity of apical portion and inner dentin cavity of coronal portion was cut a distance of about 1.0mm from the canal wall and outer dentin cavity of coronal portion was cut to a depth of about 0.5mm from root surface. 10 teeth of control group was not filled. 20 teeth were not flushed with 17% EDTA before using root canal sealers and then divided into 2 groups obturated with Sealapex and Apexit. The remaining 20 teeth were flushed with 17% EDTA and 5% NaOCl to remove smear layer and divided into 2 groups obturated with Sealapex and Apexit. The pH change of the dentin in each cavity was measured at 0, 1, 3, 5, 7, 15, 30 days with pH microelectrode(WPI Co., USA). The results were as follows: 1. The groups obturated with Sealapex and Apexit(calcium hydroxide based-sealers) have no increase in the pH level at root dentin. And there is no significant difference in pH level between groups obturated with Sealapex and Apexit(P>0.05). 2. Differences in pH levels between the treated and untreated groups with EDTA were not significant(P>0.05). 3. There is no significant difference in pH level between apical and cervical dentin, inner and outer dentin throughout the duration of the experiment(P>0.05).

• Restorative Dentistry and Endodontics
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• v.16 no.2
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• pp.62-84
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• 1991

The purpose of this study was to evaluate the cytotoxicity of four root canal sealers(Tubliseal, AH26, Apatite Root Canal Sealer I, Apatite Root Canal Sealer II) in Vitro. The root canal sealers were mixed and filled in molds which were $14{\times}1.25mm$ in diameter, in height to use for cell counting and agar overlary method, and $7{\times}1.25mm$ for millipore filter method and set for 7 days to use for experiment. Silicone and copper plate were used for negative and positive control respectively. Using the culture of L929 fibroblast, total cell number and vital cell number were counted and the ratio of vital cell number to total cell number was calculated on 2 nd, 4 th, 6 th experimental day, and the change of cell membrane permeability was tested by agar overlay method, and the succinate dehydrogenase activity was tested by millipore filter method. The obtained results were as follows. 1. In ail experimental groups, the mitotic activity of fibroblast was reduced when compared with that of negative control group, so ail experimental groups showed cytotoxicity. Apatite Root Canal Sealer I group exhibited mild cytotoxicity, and Tubliseal, AH26, Apatite Root Cenal Sealer II groups exhibited severe cytotoxicity. 2. In the test of the change of cell membrane permeability by agar overlay method, all experimental groups showed cytotoxicity. AH26 group exhibited mild cytotoxicity, and Apatite Root Canal Sealer I group exhibited moderate cytotoxicity, and Tubliseal and Apatite Root Canal Sealer II group exhibited severe cytotoxicity. 3. In the test of SDH activity by millipore filter method, there was no cytotoxicity in Apatite Root Canal Sealer I and Apatite Root Canal Sealer II group, but Tubliseal and AH26 group showed mild cytotoxicity.