Compared with cold lateral condensation and continuous wave of condensation which are classically used in clinical, newly emerging single-cone obturation technique is easy-to-operate as well as time-saving. Especially when combined with bioceramic root canal sealers of improved physicochemical and biological properties, single-cone obturation technique showed satisfactory short-term outcomes in clinical observations. However, difficulties still exist in avoiding the root canal overfilling and in operating the retreatment. Besides, the long-term effects of single-cone obturation with bioceramic sealers still remain unclear. This article makes an overview on the history and development of single-cone obturation ,and provides analysis of its pros and corns. Furthermore, we would also like to summarize its clinical application and look into its future improvements.
Epoxy Resins/chemistry* ; Gutta-Percha/chemistry* ; Retreatment ; Root Canal Filling Materials/therapeutic use* ; Root Canal Obturation/methods* ; Root Canal Therapy

This study aimed to present a new method based on numeric calculus to provide data on the theoretical volume ratio of voids when using the cold lateral compaction technique in canals with various diameters and tapers. Twenty-one simulated mathematical root canal models were created with different tapers and sizes of apical diameter, and were filled with defined sizes of standardized accessory gutta-percha cones. The areas of each master and accessory gutta-percha cone as well as the depth of their insertion into the canals were determined mathematically in Microsoft Excel. When the first accessory gutta-percha cone had been positioned, the residual area of void was measured. The areas of the residual voids were then measured repeatedly upon insertion of additional accessary cones until no more could be inserted in the canal. The volume ratio of voids was calculated through measurement of the volume of the root canal and mass of gutta-percha cones. The theoretical volume ratio of voids was influenced by the taper of canal, the size of apical preparation and the size of accessory gutta-percha cones. Greater apical preparation size and larger taper together with the use of smaller accessory cones reduced the volume ratio of voids in the apical third. The mathematical model provided a precise method to determine the theoretical volume ratio of voids in root-filled canals when using cold lateral compaction.
Dental Pulp Cavity ; drug effects ; Epoxy Resins ; therapeutic use ; Gutta-Percha ; therapeutic use ; Humans ; Models, Theoretical ; Root Canal Filling Materials ; therapeutic use ; Root Canal Preparation ; methods ; Surface Properties ; Titanium ; therapeutic use

This study examined the adhesive strength of two self-adhesive methacrylate resin-based sealers (MetaSEAL and RealSeal SE) to root dentin and compared them with RealSeal and AH Plus in properties. A total of 48 extracted human single-rooted teeth were used to prepare the 0.9-mm thick longitudinal tooth slice (each per tooth). Standardized simulated canal spaces of uniform dimensions were prepared in the middle of radicular dentin. After treated with 5.25% sodium hypochlorite (NaOCl) and 17% EDTA, tooth slices were allocated randomly to four groups (n=12) in terms of different sealers used: MetaSEAL, RealSeal SE, RealSeal, and AH plus groups. The simulated canal spaces were obturated with different sealers in each group. There were 10 slabs with 20 simulated canal spaces (n=20) used in each group for push-out testing. The failure modes and the ultrastructures of fractured sealer-dentin interfaces were examined. The remaining 2 slabs in each group underwent partial demineralization for observation of the ultrastructure of resin tags. The results showed that the push-out bond strength was 12.01±4.66 MPa in MetaSEAL group, significantly higher than that in the other three groups (P<0.05). Moreover, no statistically significant differences were noted in the push-out bond strength between RealSeal SE (5.43±3.68 MPa) and AH Plus (7.34±2.83 MPa) groups and between RealSeal SE and RealSeal (2.93±1.76 MPa) groups (P>0.05). Mixed failures were predominant in the fractured sealer-dentin interfaces in MetaSEAL and AH Plus groups, while adhesive failures were frequently seen in RealSeal SE and RealSeal groups. In conclusion, after complete removal of the smear layer, MetaSEAL showed superior bond ability to root dentin. The RealSeal SE is applicable in clinical practice, with its adhesive strength similar to that of AH Plus. The self-adhesive methacrylate resin-based sealer holds promise for use in endodontic treatment.
Adhesives ; standards ; Composite Resins ; standards ; Compressive Strength ; Dental Bonding ; Dental Pulp Cavity ; ultrastructure ; Dental Stress Analysis ; methods ; Dentin ; Dentin-Bonding Agents ; standards ; Epoxy Resins ; standards ; Humans ; Materials Testing ; methods ; Methacrylates ; standards ; Microscopy, Electron, Scanning ; Root Canal Filling Materials ; standards ; Root Canal Preparation ; Tooth Root

Biomechanical preparation of root canals with accentuated curvature is challenging. New rotatory systems, such as Reciproc, require a shorter period of time to prepare curved canals, and became a viable alternative for endodontic treatment of teeth with root dilaceration. Thus, this study aimed to report a clinical case of endodontic therapy of root with accentuated dilaceration using Reciproc single-file system. Mandibular right second molar was diagnosed as asymptomatic irreversible pulpitis. Pulp chamber access was performed, and glide path was created with #10 K-file (Dentsply Maillefer) and PathFile #13, #16 and #19 (Dentsply Maillefer) up to the temporary working length. The working length measured corresponded to 20 mm in the mesio-buccal and mesio-lingual canals, and 22 mm in the distal canal. The R25 file (VDW GmbH) was used in all the canals for instrumentation and final preparation, followed by filling with Reciproc gutta-percha cones (VDW GmbH) and AH Plus sealer (Dentsply Maillefer), using thermal compaction technique. The case has been receiving follow-up for 6 mon and no painful symptomatology or periapical lesions have been found. Despite the difficulties, the treatment could be performed in a shorter period of time than the conventional methods.
Dental Pulp Cavity ; Endodontics ; Epoxy Resins ; Follow-Up Studies ; Gutta-Percha ; Molar ; Pulpitis ; Root Canal Filling Materials ; Tooth

OBJECTIVES: The objective of this in vitro study was to evaluate and compare the cytotoxicity of four different root canal sealers i.e. Apexit Plus (Ivoclar Vivadent), Endomethasone N (Septodont), AH-26 (Dentsply) and Pulpdent Root Canal Sealer (Pulpdent), on a mouse fibroblast cell line (L929). MATERIALS AND METHODS: Thirty two discs for each sealer (5 mm in diameter and 2 mm in height) were fabricated in Teflon mould. The sealer extraction was made in cell culture medium (Dulbecco's Modified Eagle's Medium, DMEM) using the ratio 1.25 cm2/mL between the surface of the sealer samples and the volume of medium in a shaker incubator. Extraction of each sealer was obtained at 24 hr, 7th day, 14th day, and one month of interval. These extracts were incubated with L929 cell line and 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyltetrazolium bromide (MTT) assay was done. Two-way ANOVA for interaction effects between sealer and time and Post-hoc multiple comparison using Tukey's test across all the 16 different groups were used for statistical analysis. RESULTS: Apexit Plus root canal sealer was significantly less toxic than other sealers (p < 0.05) and showed higher cellular growth than control. Endomethasone N showed mild cytotoxicity. AH-26 showed severe toxicity which became mild after one month while Pulpdent Root Canal Sealer showed severe to moderate toxicity. CONCLUSIONS: Apexit Plus was relatively biocompatible sealer as compared to other three sealers which were cytotoxic at their initial stages, however, they became biocompatible with time.
Animals ; Bismuth ; Calcium Hydroxide ; Cell Culture Techniques ; Cell Line ; Dental Pulp Cavity* ; Dexamethasone ; Drug Combinations ; Epoxy Resins ; Fibroblasts ; Formaldehyde ; Hydrocortisone ; Incubators ; Mice ; Polytetrafluoroethylene ; Root Canal Filling Materials ; Silver ; Thymol ; Titanium

OBJECTIVETo observe the influence of different bonding process and three different root canal sealing materials on microstructure of root canal dentin bonding interface after fiber post and resin bonding, so as to improve clinical operation steps and to optimize fiber post resin bonding effect.

METHODSFifteen human single mandibular first premolars were selected. Three were bonded with fiber posts through Relyx Unicem conventional bonding steps after filled with root canal sealing materials of zinc oxide eugenol paste (Group A), and another three were bonded through the same steps after filled with sealing materials of Vitapex (Group B). The other nine were filled with sealing materials of AH Plus, randomly divided into three groups and bonded through different steps as follows: conventional bonding steps only (Group C), etching with 35% phosphoric acid before conventional bonding steps (Group D), and etching and coating with Singlebond 2 adhesive before conventional bonding steps (Group E). After immersed in saline solution for one week, all the roots were cut into three sections of 3 mm in thickness with emery chip and numbered as crown section, middle section and tip section respectively. The samples were observed the resin protrusion in mixed layer of dentin interface and dentinal tubules by scanning electron microscopy.

RESULTSWe observed the resin protrusion in microstructures of the roots bonded through Relyx Unicem after filled with three different root canal sealing materials (Group A, B, C, E): most obvious in the root crown sections, middle in the root middle sections and least in the root tip sections. Differences were observed in roots filled with different sealing materials: little resin protrusion were observed in crown sections only in Group A and B, but large number of resin protrusion were found in crown and middle sections in Group C-E. Compared with Group C, no more resin protrusion were found in Group D. More and elongated resin protrusions were found in Group E.

CONCLUSIONSWe recommend using AH Plus as root canal sealing materials for residual crown and root needed to strengthen by fiber post. It is no need to etch before Relyx Unicem conventional bonding steps. However, coating Singlebond 2 adhesive after acid etching has the potential to increase fiber post cementation.

Acid Etching, Dental ; methods ; Calcium Hydroxide ; Dental Bonding ; methods ; Dental Pulp Cavity ; ultrastructure ; Dentin ; ultrastructure ; Dentin-Bonding Agents ; chemistry ; Epoxy Resins ; Humans ; Mandible ; ultrastructure ; Microscopy, Electron, Scanning ; Molar ; ultrastructure ; Post and Core Technique ; Resin Cements ; Root Canal Filling Materials ; chemistry ; Silicones ; Tooth Root ; ultrastructure ; Zinc Oxide-Eugenol Cement

OBJECTIVETo introduce a modified model for quantitative testing of glucose microleakage by constant air pressure and evaluate the sealing ability of four root canal sealers including AU Plus, Roeko Seal, Cortisomol and RC Sealer.

METHODSFifty-six straight maxillary anterior teetb were randomly divided into four experimental groups with 12 samples in each group, group A: AH Plus, group B: Roeko Seal, group C: Cortisomol, group D: RC Sealer, and positive and negative control group with 4 samples in each. After regular root preparation, samples in experimental groups were obturated by cold gutta-percha lateral compaction technique with sealers according to group description. Control groups were obturated with cold gutta-percha only. Through the model above, the value of glucose microleakage from crown to root was measured at 1, 3, 5, 7, 10, 15, 20, 25, 30 days with the glucose oxidase-peroxidase method (GOD-POD).

RESULTSAt day 1, 3, 5, no significant difference of microleakage was found between group A and B (P > 0.05). The same result was also seen between group C and D. From 7 days, microleakage value in each experimental group gradually increased, and statistical difference was found between groups (P < 0.05).

CONCLUSIONThis new model using constant air pressure is easy to establish, sensitive and practical. Among all the sealers evaluated, polydimethylsiloxane based root canal sealer, Roeko Seal has the greatest sealing ability, while epoxy-amine resin based AH Plus is second and Zinc Oxide based Cortisomol and RC Sealer have the least sealing ability.

Air Pressure ; Dental Cements ; Dental Leakage ; Dental Pulp Cavity ; Epoxy Resins ; Glucose ; Gutta-Percha ; Humans ; Root Canal Filling Materials ; Zinc Oxide-Eugenol Cement

OBJECTIVES: To compared the effect of different levels of moisture of root canal on the sealing ability after filling with four different types of sealer. MATERIALS AND METHODS: Single-rooted teeth (n = 90) instrumented to and apical size of 0.06 / 45 were randomly assigned to 12 experimental groups (n = 7 per group), positive/negative control groups (n = 3 per group). The teeth of the experimental groups (a. DRY; b. PAPER POINT DRY; c. WET) were obturated with sealer (Group 1-3: Sealapex; Group 4-6: AH plus; Group 7-9: Tubuli-seal; Group 10-12: EndoRez) and warm vertical compaction method. After 7 days in 37degrees C, 100% humidity, the coronal-to-apical microleakage was evaluated quantitatively using a glucose leakage model. The leaked glucose concentration was measured with spectrophotometer at 1, 3, 7, 14, 21, and 30 days. Data were recorded ad mmol/L and statistically analysed with the two-way ANOVA and Duncan test (p = 0.05). RESULTS: Throughout the experimental period Tubuli-seal/WET (Group 9) showed the highest mean cumulative glucose penetration (178.75 mmol/L), whereas AH plus/DRY (Group 4) had the least (20.78 mmol/L). CONCLUSIONS: The results of this study demonstrated that the moisture condition of root canals at the time of obturation and the type of sealer that was used had a significant effect on leakage and sealing ability. Thus drying procedure according to sealer types is a critical step and should not be missed in endodontic treatment.
Calcium Hydroxide ; Composite Resins ; Dental Pulp Cavity ; Epoxy Resins ; Glucose ; Humidity ; Root Canal Filling Materials ; Salicylates ; Tooth

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 l(TM), Sealapex(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 den sity 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.
Aluminum ; Dental Pulp Cavity ; Dentin ; Epoxy Resins ; Root Canal Filling Materials

We evaluated in vitro microleakage of Mineral Trioxide Aggregate (MTA) powder with 4-methacryloxyethyl trimellitate anhydride (4-META) / methyl methacrylate (MMA) & tri-n-butylborane (TBB) resin as a retrograde filling material by using methylene blue dye method. Fifty-two single rooted, extracted teeth were instrumented and obturated with gutta percha and AH plus sealer. The apical 3mm of each root was resected and 3mm deep ultrasonic root end preparation was done. External surface of roots was coated with nail varnish. Prepared teeth were randomly divided into five groups; Negative control: completely covered with nail varnish; Positive control: coated with nail varnish except for apical foramen; Group 1 (retrofilled with Portland cement); Group 2 (retrofilled with MTA); Group 3 (retrofilled with MTA powder mixed with 4-META/MMA & TBB resin). Immediately after completion of root-end filling, all specimens were submerged in methylene blue dye for 72 hours in 37degrees C incubator. The roots were longitudinally sectioned and measured for extent of dye penetration by three different examiners under microscope (x10). The results were statistically analyzed using one way ANOVA and Turkey's HSD test. No leakage was evident in negative control and complete leakage in positive control group. Group 3 showed significantly less leakage than group 1 and 2 (p < 0.01). There was no significant difference between group 1 and 2 (p > 0.01). It was concluded that MTA powder with 4-META/MMA & TBB resin was excellent in reducing initial apical microleakage.
Aluminum Compounds ; Boron Compounds ; Calcium Compounds ; Drug Combinations ; Epoxy Resins ; Glutamates ; Guanine ; Gutta-Percha ; Incubators ; Methylene Blue ; Nails ; Oxides ; Paint ; Root Canal Filling Materials ; Silicates ; Tooth ; Ultrasonics ; Pemetrexed