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      In vitro analysis of the cytotoxicity and the antimicrobial effect of four endodontic sealers

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          Abstract

          Introduction

          The aim of this study was to investigate in vitro the cytotoxicity and antibacterial properties of four different endodontic sealers using human periodontal ligament fibroblast cell proliferation and visual analysis of growth inhibition.

          Methods

          A silicone (GuttaFlow), silicate (EndoSequence BC), zinc oxide eugenol (Pulp Canal Sealer EWT) and epoxy resin (AH Plus Jet) based sealer were incubated with PDL fibroblasts (10 4 cells/ml, n = 6) up to 96 h. Cell proliferation (RFU) was determined by means of the Alamar Blue assay. Cell growth and morphology was visualized by means of fluorescent dyes. Possible antibacterial properties of the different sealers were visualized by means of SEM ( Enterococcus faecalis; Parvimonas micra).

          Results

          Fibroblast proliferation depended on sealer and cultivation time. After 72 and 96 h GuttaFlow and EndoSequence BC showed relatively non-cytotoxic reactions, while Pulp Canal Sealer EWT and AH Plus Jet caused a significant decrease of cell proliferation (p < 0.001). Visualization of cell growth and morphology with various fluorescent dyes supplemented the results. No antibacterial effect of EndoSequence BC to P. micra was found, whereas GuttaFlow showed a weak, Pulp Canal Sealer EWT and AH Plus Jet extensive growth inhibition. Also, no antibacterial effect of GuttaFlow, EndoSequence BC or AH Plus Jet to E. faecalis could be detected.

          Conclusions

          These in vitro findings reveal that GuttaFlow and EndoSequence BC can be considered as biocompatible sealing materials. However, prior to their clinical employment, studies regarding their sealing properties also need to be considered.

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          Most cited references33

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          Pathogenesis of apical periodontitis and the causes of endodontic failures.

          Apical periodontitis is a sequel to endodontic infection and manifests itself as the host defense response to microbial challenge emanating from the root canal system. It is viewed as a dynamic encounter between microbial factors and host defenses at the interface between infected radicular pulp and periodontal ligament that results in local inflammation, resorption of hard tissues, destruction of other periapical tissues, and eventual formation of various histopathological categories of apical periodontitis, commonly referred to as periapical lesions. The treatment of apical periodontitis, as a disease of root canal infection, consists of eradicating microbes or substantially reducing the microbial load from the root canal and preventing re-infection by orthograde root filling. The treatment has a remarkably high degree of success. Nevertheless, endodontic treatment can fail. Most failures occur when treatment procedures, mostly of a technical nature, have not reached a satisfactory standard for the control and elimination of infection. Even when the highest standards and the most careful procedures are followed, failures still occur. This is because there are root canal regions that cannot be cleaned and obturated with existing equipments, materials, and techniques, and thus, infection can persist. In very rare cases, there are also factors located within the inflamed periapical tissue that can interfere with post-treatment healing of the lesion. The data on the biological causes of endodontic failures are recent and scattered in various journals. This communication is meant to provide a comprehensive overview of the etio-pathogenesis of apical periodontitis and the causes of failed endodontic treatments that can be visualized in radiographs as asymptomatic post-treatment periapical radiolucencies.
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            Antibacterial activity of endodontic sealers by modified direct contact test against Enterococcus faecalis.

            The antibacterial effectiveness of 7 different endodontic sealers, AH Plus, Apexit Plus, iRoot SP, Tubli Seal, Sealapex, Epiphany SE, and EndoRez against Enterococcus faecalis was studied in vitro. A modified direct contact test was used. Bacteria in suspension were exposed to the materials for 2-60 minutes by using sealers that were freshly mixed or set for 1, 3, and 7 days. The pH values and contact angles of sterile water on sealers at different times after setting were also measured. Fresh iRoot SP killed all bacteria in 2 minutes, AH Plus in 5 minutes, EndoRez in 20 minutes, and Sealapex and Epiphany in 60 minutes. Freshly mixed Apexit Plus and Tubli Seal failed to kill all bacteria at 60 minutes. For 1-day and 3-day samples, iRoot SP and EndoRez had the strongest antibacterial activity, followed by Sealapex and Epiphany; Tubli Seal and AH Plus did n'ot show any significant antibacterial activity. Of all the samples, Apexit Plus had the lowest antimicrobial activity. The pH of the sealers could not alone explain their antibacterial effect. Fresh iRoot SP, AH Plus, and EndoRez killed E. faecalis effectively. IRoot SP and EndoRez continued to be effective for 3 and 7 days after mixing. Sealapex and EndoRez were the only ones with antimicrobial activity even at 7 days after mixing.
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              The antibacterial action of sodium hypochlorite and EDTA in 60 cases of endodontic therapy.

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                Author and article information

                Journal
                Head Face Med
                Head & Face Medicine
                BioMed Central
                1746-160X
                2011
                10 August 2011
                : 7
                : 15
                Affiliations
                [1 ]Department of Operative Dentistry, University Medical Centre of the Johannes Gutenberg University Mainz, Germany
                Article
                1746-160X-7-15
                10.1186/1746-160X-7-15
                3164599
                21831282
                36553946-e977-4daa-ba22-512d42615c8b
                Copyright ©2011 Willershausen et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 April 2011
                : 10 August 2011
                Categories
                Research

                Orthopedics
                e. faecalis p. micra,cytotoxicity,in vitro study,root canal sealer
                Orthopedics
                e. faecalis p. micra, cytotoxicity, in vitro study, root canal sealer

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