• 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.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.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.16 no.1
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• pp.25-40
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• 1991

Four root canal sealers, Apatite Root Sealer I and II composed mainly of hydroxyapatite/tricalciumphosphate, Sealapex containing calcium hydroxide, and Roth Sealer composed of zinc oxide - eugenol were compared on the culture of L929 fibroblasts. MIT (Methyl Thiazole Tetrazolium Bromide) colorimetric technique was used to measure the mitochondrial dehydrogenase activity. Results were as follows: 1. Hydroxyapatite/tricalcium phosphate mixed sealers were significantly less toxic compared with calcium hydroxide and zinc oxide - eugenol type sealers. High pH of the calcium hydroxide sealer and release of eugenol component from the zinc oxide - eugenol type sealer were presumed to be the cause of the toxicity of these two sealers. In no cases, there were more cytoblastic effects in hydroxyapatite/tricalcium phosphate mixed sealers compared to the control groups. 2. In all experimental groups, toxicity was decreased as dilutions were increased. However in zinc oxide-eugenol type sealer the cell activity was weakened for all dilution groups. 3. Regarding the effect of setting time, Apatite I and Sealapex were less toxic as the setting progressed. Apatite II kept constant regardless of the different time ellapsed after setting but Roth sealer revealed significantly higher toxicity for all experimental groups. 4. Comparing two different culture periods of 24 hours and 72 hours, Apatite I showed higher cell activities in longer period(72 hours) while Apatite II did not. Sealapex and Roth sealer, however, showed significantly lower cell activities in longer period.

• Restorative Dentistry and Endodontics
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• v.7 no.1
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• pp.85-99
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• 1981

This study was to evaluate the cytotoxic effect of three root canal disinfectants (formocresol, camphorated phenol and eugenol) and ten root canal sealers(Cavitec, Hypo-cal, Vitapex, AH26, Canals, Mynol, $N_2$, $N_2$-Medical, Z. O. E. and Calvital) in vitro. The experiments were performed in four differrent modes. In the first and second experiment, the "long-distance" cytotoxicity of three root canal disinfectants were tested on L cells. In the third exeriment, ten root canal sealers were tested for cytotoxicity by means of the tissue culture-agar overlay method immediately, 4 and 24 hours after the experiment. In the fourth experiment, the study with radioactively labeled L cells were employed to determine the relative cytotoxicity of ten root canal sealers. The results were as follows; 1. Every vapors from disinfectants showed more or less cytotoxicity. Of the three disinfectats, formocresol appeared to be the highest cytotoxic effect and camphorated phenol was the lowest. 2. Root canal sealers tested in tbis study showed cytotoxicity at every stage of time intervals. 3. The highest cytotoxic effect was freshly mixed $N_2$ meaical and $N_2$ also revealed the highest cytotoxic effect after 4 or 24 hours among these materials. Vitapex was found the lowest cytotoxic effect at all experimental stage. 4. Root canal sealers except N2 and Mynol showed cytotoxic effect were decreased cytotoxicity according to the time elapsed.

• Journal of Korean Dental Science
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• v.2 no.1
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• pp.11-18
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• 2009

The purpose of this study was to investigate the possibility to reduce the toxicity of oil based root canal sealers containing calcium hydroxide using MTT & agar overlay assays. Thus some formulations of traditional root canal sealers were replaced with oil-soluble solvents and experimental root canal sealers manufactured. In MTT assay, Cell viability of all experimental sealers in addition with oil soluble solvents were observed significantly higher than both control groups, especially according to replace zinc and/or calcium ion components. Also agar overlay assay was appeared moderate to no cell responses into modifying both zinc and/or calcium ion components and oil soluble solvent weight. Authors found the reducing effect of cell toxicity through significant role of oil soluble solvent factor into root canal sealer containing calcium hydroxide.

• Restorative Dentistry and Endodontics
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• v.49 no.1
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• pp.5.1-5.11
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• 2024

Objectives: This study aimed to present the results and analyses of clinical trials, including updates on the different functions of root canal sealers. Materials and Methods: In June 2023, we performed a comprehensive search of ClinicalTrials.gov to identify interventional clinical trials pertaining to root canal sealers. In total, 23 clinical trials conducted up to June 2023 were included in this study. Results: Approximately half of the trials (11 out of 23) were completed, while none were terminated or withdrawn. Each included trial had a minimum of 10 participants, with 11 trials having more than 100 participants. None of the assessed trials provided outcomes, and the majority (17 out of 23) lacked associated publications. In terms of geographic distribution, the USA and Canada did not contribute to any root canal sealer trials. Conclusions: This study highlights the lack of diversity in trial locations, the absence of reported results, and a scarcity of clinical trials examining the physicochemical properties of different sealers. Most published trials primarily focused on assessing the post-operative pain effect of these sealers, but no significant difference was found regarding post-operative pain control.

• The Journal of the Korean dental association
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• v.56 no.5
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• pp.254-262
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• 2018

Objectives: This study aimed to compare the postoperative pain and clinical performance after applying three different intracanal medicaments and root canal sealers. Materials and Methods: Sixty-five patients requiring root canal treatment due to symptomatic apical periodontitis were included in this study. After a glide path preparation by using PathFile, each canal was shaped with ProTaper Next file system. After the canal cleaning and shaping procedure, the canal was dried and each intracanal medicaments were adjusted (Calcipex II, TRC-paste, Metapaste). At the next visit, the patients were requested to answer the absence of the pain after the procedure. Once the patients showed no symptom, the canal was obturated with each corresponded root canal sealers (AH plus, Radic-sealer, ADseal). The patients were recalled after 1 week, 1, 3, and 6 months to check the postoperative pain or unexpected clinical signs. One-way ANOVA and Duncan's post hoc comparison, and Chi-square test were used for statistical analysis to evaluate any differences among tested materials. Results: The average number of visits for intracanal medication was 2.69, 2.65, and 2.61 for Calcipex II, TRC-paste, and Metapaste. There were no statistically differences in post-obturation pain among three groups obturated with different root canal sealers (P > 0.05). Conclusions: Under the limitations of this study, three tested intracanal medicaments and epoxy resin root canal sealers showed clinically acceptable similar results.

• 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.

• Proceedings of the Korea Concrete Institute Conference
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• 2005.11a
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• pp.567-570
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• 2005

This study aims to verify the relationship between the penetration depth and chemical resistance, which can demonstrates the performance of the applied surface penetration sealers.