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      An In Vitro Comparative Evaluation of Apical Leakage Using Different Root Canal Sealers

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          Abstract

          Background

          Successful endodontic therapy requires a fluid-tight apical seal. The aim of this in vitro study was to evaluate and compare the apical sealing ability of 3 root canal sealers: Apexit Plus, AH Plus, and Resilon/Epiphany sealers.

          Material/Methods

          Samples of 152 single-rooted teeth were divided into 2 test groups, and each group was divided into 3 subgroups based on the preparation and obturation technique. After preparation with the step-back technique, the first group of root canals were obturated with lateral gutta-percha compaction in combination with AH Plus sealer or Apexit Plus or with the Resilon/Epiphany system alone. In the second group, preparation was done with the crown-down technique and root canals were then obturated with Thermafil obturator in combination with AH Plus or Apexit Plus or with Resilon/Epiphany sealer alone. Apical leakage was determined using a dye leakage test observed with a stereomicroscope. The degree of dye leakage was assessed using the t test to comparing the arithmetic averages of the groups.

          Results

          In the groups prepared with the step-back technique, the average dye leakage was lower in samples obturated with Resilon/Epiphany, than in those filled with AH Plus/lateral gutta-percha compaction or Apexit Plus/lateral gutta-percha compaction. In groups prepared with the crown-down technique and obturated with the Resilon/Epiphany system, the average dye leakage was lower than in those filled with AH Plus/Thermafil obturation and those filled with Apexit Plus/Thermafil obturation.

          Conclusions

          Although all preparation and obturation techniques showed dye penetration, the crown-down technique paired with the Resilon/Epiphany system showed the least leakage.

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          Most cited references51

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          Periapical health related to the quality of coronal restorations and root fillings.

          To evaluate the impact of the quality of coronal restorations scored on a clinical and radiographic basis and the quality of root fillings on periapical health. Periapical radiographs were taken of 745 root-filled teeth, randomly selected from patients attending the Ghent University Dental School. The teeth had not received restorative treatment in the previous year. The coronal status was scored both clinically according to modified Ryge's criteria, and radiographically by evaluating the presence of signs of marginal leakage or decay. The quality of the root filling was scored according to criteria of length and homogeneity and the periapical status was categorized on the basis of presence or absence of radiographic signs of apical periodontitis. The relationship between coronal status, quality of root filling and periapical health was determined. The data were analyzed using Chi2 test, Odds ratio, Spearman's r(S) and logistic regression. Thirty-three percent of the teeth had apical periodontitis as diagnosed radiographically. Teeth with good and poor coronal restorations scored clinically had apical periodontitis in 31.1 and 36.8%, respectively; this difference was not statistically significant. The quality of the coronal restorations scored radiographically had a statistically significant influence on the periapical condition (P<0.001) with apical periodontitis in 23.8 and 49.1%, respectively, for acceptable and unacceptable restorations. Marginal decay did not influence the periapical status. Teeth restored without a base under the coronal filling had apical periodontitis in 41.3%, whereas teeth with a base had significantly less (P<0.005) apical periodontitis (25.9%). Composite-restored teeth exhibited apical periodontitis in 40.5% of cases whilst amalgam-restored teeth had apical periodontitis in 28.4% of cases; this difference was statistically significant (P<0.01). Root-canal posts had no influence on periapical health. The length and homogeneity of the root-canal fillings had a significant influence (P<0.01 and P<0.001, respectively) on the presence of apical periodontitis, as well as the quality of the coronal restoration scored radiographically (P<0.001). The importance of a good coronal restoration, as well as of a good root filling should be emphasized as the technical quality of both influencing the periapical status.
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            A comparative study of selected physical properties of five root-canal sealers.

            To investigate selected physical properties of five root-canal sealers. The solubility, film thickness, flow, working and setting times of Roth 801, Tubli-Seal EWT, AH Plus, Apexit and Endion were evaluated. Solubility was measured by weight change of standard specimens in water over a 3-month period. Film thickness was measured as the distance between weighted glass slides containing a standard quantity of sealer. Flow was assessed by rate of sealer extrusion through a standard bore diameter, after unit time. Working time was taken as the point at which flow rate was reduced by 10%. The indentation test using a modified Gilmore needle was employed to investigate the setting times. AH Plus was the least soluble, whilst Apexit was the most unstable in water. The solubility values in increasing order were: AH Plus
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              Ability of new obturation materials to improve the seal of the root canal system: a review.

              New obturation biomaterials have been introduced over the past decade to improve the seal of the root canal system. However, it is not clear whether they have really produced a three-dimensional impervious seal that is important for reducing diseases associated with root canal treatment. A review of the literature was performed to identify models that have been employed for evaluating the seal of the root canal system. In vitro and in vivo models are not totally adept at quantifying the seal of root canals obturated with classic materials. Thus, one has to resort to clinical outcomes to examine whether there are real benefits associated with the use of recently introduced materials for obturating root canals. However, there is no simple answer because endodontic treatment outcomes are influenced by a host of other predictors that are more likely to take precedence over the influence of obturation materials. From the perspective of clinical performance, classic root filling materials have stood the test of time. Because many of the recently introduced materials are so new, there is not enough evidence yet to support their ability to improve clinical performance. This emphasizes the need to translate anecdotal information into clinically relevant research data on new biomaterials.
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                Author and article information

                Journal
                Med Sci Monit Basic Res
                Med Sci Monit Basic Res
                Medical Science Monitor Basic Research
                Medical Science Monitor Basic Research
                International Scientific Literature, Inc.
                2325-4394
                2325-4416
                2020
                25 November 2020
                : 26
                : e928175-1-e928175-8
                Affiliations
                [1 ]Department of Dental Pathology and Endodontics, Faculty of Medicine, University of Prishtina, Prishtina, Kosovo
                [2 ]Department of Operative Dentistry and Endodontology, University for Business and Technology, Prishtina, Kosovo
                [3 ]Department of Dental Pathology and Endodontics, AAB College, Prishtina, Kosovo
                [4 ]Private Dentistry Clinic “Viodent”, Prishtina, Kosovo
                Author notes
                Corresponding Author: Nexhmije Ajeti, e-mail: nexhmije.ajeti@ 123456ubt-uni.net
                [A]

                Study Design

                [B]

                Data Collection

                [C]

                Statistical Analysis

                [D]

                Data Interpretation

                [E]

                Manuscript Preparation

                [F]

                Literature Search

                [G]

                Funds Collection

                Article
                928175
                10.12659/MSMBR.928175
                7702640
                33235182
                85513d2d-a068-442b-bd74-0cccdf0735a6
                © Med Sci Monit, 2020

                This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International ( CC BY-NC-ND 4.0)

                History
                : 24 August 2020
                : 03 November 2020
                Categories
                Human Study

                endodontics,gutta-percha,root canal filling materials

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