Virtual Approach to the Comparative Analysis of Biomaterials Used in Endodontic Treatment

The importance of endodontics is presented within our own concept of Dentistry Sustainable Development (DSD) consisting of three inseparable elements; i.e., Advanced Interventionist Dentistry 4.0 (AID 4.0), Global Dental Prevention (GDP), and the Dentistry Safety System (DSS) as a polemic, with the hypothesis of the need to abandon interventionist dentistry in favour of the domination of dental prevention. In view of the numerous systemic complications of caries that affect 3−5 billion people globally, endodontic treatment effectively counteracts them. Regardless of this, the prevention of oral diseases should be developed very widely, and in many countries dental care should reach the poorest sections of society. The materials and methods of clinical management in endodontic procedures are characterized. The progress in the field of filling materials and techniques for the development and obturation of root canals is presented. The endodontics market is forecast to reach USD 2.1 billion in 2026, with a CAGR of 4.1%. The most widely used and recognized material for filling root canals is gutta-percha, recognized as the “gold standard”. An alternative is a synthetic thermoplastic filler material based on polyester materials, known mainly under the trade name Resilon. There are still sceptical opinions about the need to replace gutta-percha with this synthetic material, and many dentists still believe that this material cannot compete with gutta-percha. The results of studies carried out so far do not allow for the formulation of a substantively and ethically unambiguous view that gutta-percha should be replaced with another material. There is still insufficient clinical evidence to formulate firm opinions in this regard. In essence, materials and technologies used in endodontics do not differ from other groups of materials, which justifies using material engineering methodology for their research. Therefore, a detailed methodological approach is presented to objectify the assessment of endodontic treatment. Theoretical analysis was carried out using the methods of procedural benchmarking and comparative analysis with the use of contextual matrices to virtually optimize the selection of materials, techniques for the development and obturation of root canals, and methods for assessing the effectiveness of filling, which methods are usually used, e.g., in management science, and especially in foresight research as part of knowledge management. The results of these analyses are presented in the form of appropriate context matrices. The full usefulness of the research on the effectiveness and tightness of root canal filling using scanning electron microscopy is indicated. The analysis results are a practical application of the so-called “digital twins” approach concerning the virtual comparative analysis of biomaterials used in endodontic treatment.

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ESTIMATION OF QUALITY PROCESSING OF ROOT CANALS AFTER RE-ENDODONTIC TREATMENT BY THE METALLOGRAPHIC EXAMINATION

The actual problems in dentistry ◽

10.18481/2077-7566-2013-0-5-18-20 ◽

2013 ◽

Vol 9 (5) ◽

pp. 18-20

Author(s):

П. Панфилов ◽

P. Panfilov ◽

С. Григорьев ◽

S. Grigoriev ◽

А. Курищев ◽

...

Keyword(s):

Optical Metallography ◽

Endodontic Treatment ◽

Metallographic Examination ◽

Root Canals ◽

Filling Materials ◽

Gutta Percha ◽

Methods Of Treatment

The morphology of the walls of root canals was studied by optical metallography (untreated teeth and teeth with various methods of treatment). The channel walls in the upper and middle parts do not contain traces of pulp and filling materials after treatment. At the top of the root may be traces of gutta-percha and siller.

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The effect of timing temporary cements to treat induced pulp necrosis in the teeth of dogs

Pesquisa Veterinária Brasileira ◽

10.1590/s0100-736x2007000200006 ◽

2007 ◽

Vol 27 (2) ◽

pp. 85-88

Author(s):

Léslie M. Domingues-Falqueiro ◽

Jonathan Ferreira ◽

Fernanda M. Lopes ◽

Agnes Tymoszczenko ◽

Marco A. Gioso

Keyword(s):

Root Canal ◽

Microbial Reduction ◽

Endodontic Treatment ◽

Microbiological Analysis ◽

Single Session ◽

Root Canal Filling ◽

Root Canals ◽

Gutta Percha ◽

Dressing Materials ◽

Block Section

During endodontic therapy (pulpectomy, root canal debridement and root canal filling) microbiological management is a major concern. Bacteria present in dentine tubules, apical foramina and apical delta are causally related to failure of the procedure. Studies have shown that during single session endodontic treatment bacteria remain within dental structures. The aim of the present study was to evaluate endodontic treatment performed as two sessions, using temporary endodontic dressing materials for different periods in four groups of experimental dogs. A total of 80 roots of second and third upper premolar teeth and second, third and fourth lower premolar teeth were divided into four groups. The pulp chamber was opened with burrs and the pulp exposed for 60 days to induce pulpal inflammation and necrosis. Groups II, III and IV were treated with calcium hydroxide plus camphorated paramono-chlorophenol (PMCC) for 7, 15 and 30 days, respectively. In all groups, the root canals were filled with zinc oxide-eugenol and gutta-percha cones. Clinical and radiographical measurements were performed every 2 weeks. After 60 days a small block section containing the teeth, surrounding periapical tissues and the periodontium was removed for histological and microbiological study. Histological analysis revealed intense inflammatory response in all groups. Microbiological analysis showed microbial reduction inversely proportional to the period of time that the intracanal temporary medicament was left in place.

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In Vivo Comparative Evaluation of Periapical Healing in Response to a Calcium Silicate and Calcium Hydroxide Based Endodontic Sealers

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2018.293 ◽

2018 ◽

Vol 6 (8) ◽

pp. 1475-1479 ◽

Cited By ~ 2

Author(s):

Dalia Y. Zaki ◽

Mohamed H. Zaazou ◽

Maram E. Khallaf ◽

Tamer M. Hamdy

Keyword(s):

Calcium Hydroxide ◽

Root Canal ◽

Calcium Silicate ◽

Negative Control ◽

Root Canal Filling ◽

Root Canals ◽

Filling Materials ◽

Gutta Percha ◽

Periapical Healing

BACKGROUND: The composition of the root canal filling materials together with the apical limit of the root canal obturation affect the complete periapical healing after root canal therapy.AIM: This study was performed to evaluate and compare the periapical healing in response to calcium-silicate (iRoot SP) and calcium-hydroxide (Apexit) based-sealers.MATERIAL AND METHODS: Seventy-two upper premolars root canals of six dogs were used. The teeth were randomly assigned to four groups: Group one: roots were obturated using gutta-percha and Apexit-sealer; Group two: roots were obturated using gutta-percha&iRoot SP-sealer; Group three: the teeth were left open without obturation; Group four: where healthy teeth were used as a negative control. Teeth were evaluated after one, two and three months. The newly formed mineralised apical tissue and the periapical inflammatory infiltrate of the obtained photomicrographs were evaluated, and scorings were statistically-analysed.RESULTS: The mean percentage of the periapical inflammatory infiltrates and mineralisation scoring after one, two and three months evaluation period were not significantly different among the four groups (P > 0.05).CONCLUSIONS: Regardless of the sealer used, iRoot SP and Apexit promote healing of periapical tissues. IRoot SP sealer showed early insignificant more partial and almost full healing after two and three months.

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Development Strategy of Endodontic Filling Materials Based on Engineering and Medical Approaches

Processes ◽

10.3390/pr9112014 ◽

2021 ◽

Vol 9 (11) ◽

pp. 2014

Author(s):

Leszek A. Dobrzański ◽

Joanna Dobrzańska ◽

Lech B. Dobrzański ◽

Anna D. Dobrzańska-Danikiewicz ◽

Klaudiusz Gołombek

Keyword(s):

Development Strategy ◽

Root Canal ◽

Virtual Space ◽

Endodontic Treatment ◽

Filling Material ◽

Root Canals ◽

Filling Materials ◽

Gutta Percha ◽

Life Years ◽

Selection Of

This article is a literature review aimed at presenting the general state of knowledge in manufacturing engineering and materials engineering to develop engineering materials applied for endodontic treatment as filling materials. Particular attention was paid to theoretical analyses concerning the selection of methods for developing and obturating root canals and discussing the results of experimental studies available in the literature. These activities aimed to compare the importance of the most commonly used endodontic filling materials based on gutta-percha or polymeric polyester materials, commonly known as resilon, respectively. The motivation to take up this complex, multi-faceted topic in this paper is the extent of caries, periodontal disease, and other oral diseases in 3 to 5 billion people, often affecting toothlessness and contributing to an increase in the index of disability-adjusted life years (number). Endodontics is an important element of the authors’ concept of Dentistry Sustainable Development (DSD) > 2020. The principles of qualifying patients for endodontic treatment are discussed. The introduction of rotary tools, especially manufactured from Nitinol alloy, to develop root canals and the latest thermohydraulic and condensation techniques for obturation guarantee progress in endodontics. The “Digital Twins” methodology was used, rooted in the idea of Industry 4.0 and the resulting idea of Dentistry 4.0, as well as knowledge management methods, to perform experimental research in virtual space, concerning methods of developing and obturating the root canal and assessing the tightness of fillings. Microscopic visualization methods were also used. Significant factors determining the effectiveness of endodontic obturation are the selection of the filling material and the appropriate obturation method. The generalized dendrological matrix of endodontic filling materials considers the criteria of mechanical strength influencing the potential root fracture and the quality of root canal filling. The results of the SWOT point analysis (strengths and weaknesses, opportunities, threats) were also compared. For both filling materials, the weaknesses are much less than the strengths, while the threats are slightly less than the opportunities for the gutta-percha-based material, while for resilon the opportunities are much smaller than the threats. It requires the application of an appropriate development strategy, i.e., MAXI-MAXI in the case of a filling material based on gutta-percha and MAXI-MINI in the case of resilon. Therefore, the analysis of these experimental data does not indicate the real competitiveness of resilon for the gutta-percha-based material. This material deservedly maintains its strong position as the “Gold Standard of Endodontics”.

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3D Analysis of D-RaCe and Self-Adjusting File in Removing Filling Materials from Curved Root Canals Instrumented and Filled with Different Techniques

The Scientific World JOURNAL ◽

10.1155/2014/836513 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Neslihan Simsek ◽

Fuat Ahmetoglu ◽

Ali Keles ◽

Elcin Tekin Bulut ◽

Kursat Er

Keyword(s):

Ct Scans ◽

3D Analysis ◽

Filling Material ◽

Micro Ct ◽

Root Canal Filling ◽

Root Canals ◽

Filling Materials ◽

Gutta Percha ◽

Ah Plus ◽

Curved Root Canals

The aim of this study was to compare the efficacy of D-RaCe files and a self-adjusting file (SAF) system in removing filling material from curved root canals instrumented and filled with different techniques by using microcomputed tomography (micro-CT). The mesial roots of 20 extracted mandibular first molars were used. Root canals (mesiobuccal and mesiolingual) were instrumented with SAF or Revo-S. The canals were then filled with gutta-percha and AH Plus sealer using cold lateral compaction or thermoplasticized injectable techniques. The root fillings were first removed with D-RaCe (Step 1), followed by Step 2, in which a SAF system was used to remove the residual fillings in all groups. Micro-CT scans were used to measure the volume of residual filling after root canal filling, reinstrumentation with D-RaCe (Step 1), and reinstrumentation with SAF (Step 2). Data were analyzed using Wilcoxon and Kruskal-Wallis tests. There were no statistically significant differences between filling techniques in the canals instrumented with SAF (P=0.292) and Revo-S (P=0.306). The amount of remaining filling material was similar in all groups (P=0.363); all of the instrumentation techniques left filling residue inside the canals. However, the additional use of SAF was more effective than using D-RaCe alone.

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A histologic study comparing Hydron and gutta-percha as root canal filling materials in monkeys

Journal of Endodontics ◽

10.1016/s0099-2399(81)80037-4 ◽

1981 ◽

Vol 7 (9) ◽

pp. 396-401 ◽

Cited By ~ 9

Author(s):

John P. Tanzilli ◽

Alan J. Nevins ◽

Bernard G. Borden

Keyword(s):

Root Canal ◽

Histologic Study ◽

Root Canal Filling ◽

Filling Materials ◽

Gutta Percha ◽

Root Canal Filling Materials

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Influence of calcium hydroxide points on the quality of intracanal dressing filling

Journal of Applied Oral Science ◽

10.1590/s1678-77572006000300014 ◽

2006 ◽

Vol 14 (3) ◽

pp. 219-223 ◽

Cited By ~ 2

Author(s):

Nicole de Mello Rahde ◽

José Antonio Poli Figueiredo ◽

Elias Pandonor Motcy Oliveira

Keyword(s):

Calcium Hydroxide ◽

Root Canal Filling ◽

Human Teeth ◽

Significance Level ◽

Root Canals ◽

Gutta Percha ◽

Group 2 ◽

Post Hoc

PURPOSE: The aim of this study was to evaluate, in vitro, the quality of calcium hydroxide [Ca(OH)2] paste filling (Ultracal, Ultradent) associated or not with Ca(OH)2-containing gutta-percha points (Calcium Hydroxide Plus PointsTM, Roeko) in curved root canals. MATERIAL AND METHODS: One hundred and twenty roots of extracted human teeth, randomly divided into three curvature ranges (mild - 0 to 14º; moderate - 15º to 29º; severe - >30º) were used. After chemomechanical preparation, the roots were assigned to 4 groups (n=30), according to the technique of intracanal dressing placement: group 1 - Ca(OH)2 paste was applied with a lentulo spiral; group 2 - Ca(OH)2 paste was applied with a lentulo spiral and a Ca(OH)2 point was inserted into the canal; group 3 - Ca(OH)2 paste was applied with a NavitipTM tip (supplied with Ultracal system); group 4 - Ca(OH)2 paste was applied with a NavitipTM tip and a Ca(OH)2 point was inserted into the canal. The roots were cleared and the quality of apical third filling was assessed by a calibrated experienced examiner. The specimens were examined under stereomicroscopy and scored 1 to 4 (i.e., from inadequate to complete root canal filling). The results were analyzed statistically by ANOVA and Duncan's post hoc test at 5% significance level. RESULTS: There were no statistically significant differences (p>0.05) among the curvature degrees in groups 1, 3 and 4. Severely curved roots in group 2 presented bordering significance (p=0.05). The groups that associated the use of Ca(OH)2 paste and points (2 and 4) showed better apical filling than the other groups, but this difference was statistically significant (p<0.001) only for roots with severe curvature. CONCLUSION: According to the results of this study, the curvature degree did not influence the quality of filling. The techniques that used Ca(OH)2-containing gutta-percha points yielded better filling of the apical third in roots with severe curvature.

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Antimicrobial activity of root canal filling materials

International Journal of Clinical Case Reports and Reviews ◽

10.31579/2690-4861/116 ◽

2021 ◽

Vol 7 (1) ◽

pp. 01-05

Author(s):

Jikia Maia

Keyword(s):

Staphylococcus Aureus ◽

Antimicrobial Activity ◽

Zinc Oxide ◽

Antimicrobial Properties ◽

Root Canal Filling ◽

Root Canals ◽

Filling Materials ◽

Zinc Oxide Eugenol ◽

Test Culture

The antimicrobial activity of filling materials was studied to improve the quality of treatment of complicated caries in vitro. Resorcin-formalin cement Resodont (“Latus”, Ukraine) - № 1; Endocort zinc oxide-eugenol cement (“Latus”, Ukraine) - No. 2; materials based on zinc oxide eugenol cement with dexamethasone: Endomethasone ivory (Septodont, France) - No. 3 and Endofil ("Produit Dentaires SA", Switzerland) - No. 4. To assess the antimicrobial activity of the studied materials, test microorganism strains were used: Staphylococcus aureus ATCC 25923, Enterococcus faecalis ATCC 6783, Candida albicans ATCC 885-653. As a result of the study, it was established that filling materials have different antimicrobial activity. Resodont has the greatest antimicrobial activity on the test culture. Endomethason is active in relation to the test cultures studied, inferior to Resodont in its antimicrobial properties. Endocort and Endofil have less antimicrobial activity than Resodont and Endomethason, but have approximately equal growth retardation rates. It should be noted that with respect to Staphylococcus aureus, Endocort was found to be almost 1.5 times more active than Endofil. The conducted studies confirm that the materials for filling of root canals by Resodont and Endocort (Latus, Ukraine) have a pronounced antibacterial effect. They are competitive with foreign sealers and are the materials of choice, having a significantly lower cost.

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Evolutionary Leap in Endodontics. Case report

Research Society and Development ◽

10.33448/rsd-v10i3.13538 ◽

2021 ◽

Vol 10 (3) ◽

pp. e44110313538

Author(s):

Jose Maurício Paradella de Camargo ◽

Rafael Verardino de Camargo ◽

Luciano Tavares Angelo Cintra ◽

Flávio Duarte Faria ◽

Alberto Consolaro ◽

...

Keyword(s):

Conventional Technique ◽

Endodontic Treatment ◽

Radiographic Examination ◽

Risk Of Fracture ◽

Root Canals ◽

Gutta Percha ◽

Ah Plus ◽

Niti Instruments ◽

Antiseptic Solutions ◽

Reduced Risk

The Leap protocol combines the newest and most active association of reciprocal-rotary instrumentation, aluminum insert ultrasonic, and diode laser. The reciprocal-rotary technique consists of Niti instruments used in different motions depending on the stage of the treatment and promotes the balanced cutting effectiveness and reduced risk of fracture files. Moreover, it creates a centered and tapered shape. The aluminum tip for the ultrasonic unit delivers agitation, emulsification, and cavitation of antiseptic solutions that improve the cleaning. The dye and laser use cause the ablation and final disinfection. This paper describes the case of a patient with asymptomatic apical periodontitis in an upper first right molar submitted to endodontic treatment performed with Leap protocol. After conventional procedures, the root canals were prepared by using reciprocal-rotary instrumentation techniques. Between each file a new solution was placed and activated with the ultrasonic handpiece. At the end of instrumentation, the root canals were aspirated, dried with paper points, the indocyanine dye was placed into the root canals and, DaVinci laser was used for 30 seconds. The gutta-percha cones matching the final Niti file were used coated with AH Plus sealer. A periapical radiograph was taken to verify obturation and its anatomical complexity. Six months after the procedure, the patient was asymptomatic, and the radiographic examination showed healthy periradicular tissues. It is concluded that the use of Leap protocol in conventional endodontic treatment was effective, suggesting that this therapy may provide additional benefits to patients when compared to the conventional technique.

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Radiographic and scanning electron microscopic assessment of root canal filling remnants after endodontic re-instrumentation

Brazilian Dental Science ◽

10.14295/bds.2017.v20i1.1325 ◽

2017 ◽

Vol 20 (1) ◽

pp. 80 ◽

Cited By ~ 1

Author(s):

Luciane Geanini Pena Santos ◽

Wilson Tadeu Felippe ◽

Beatriz Dulcineia Mendes Souza ◽

Andrea Cristina Konrath ◽

Mabel Mariela Rodríguez Cordeiro ◽

...

Keyword(s):

Electron Microscopy ◽

Scanning Electron Microscopy ◽

Root Canal ◽

Filling Material ◽

Root Canal Filling ◽

Root Canals ◽

Filling Materials ◽

Ah Plus ◽

Endodontic Retreatment ◽

Scanning Electron

Objective: Failures in endodontic treatment may occur by several reasons. Endodontic retreatment is an interesting alternative to manage this clinical problem. However, it is not possible to completely remove the root canal filling by any current retreatment technique. The aim of this study was to evaluate the presence of residual root canal filling materials after endodontic re-instrumentation. Material and Methods: Sixty extracted anterior human teeth were prepared by step-back technique with Flexofiles, K-files and Gates-Glidden (GG) burs. Between the use of each file or bur, root canals were irrigated with sodium hypochlorite (NaOCl). Smear layer was removed by irrigation with ethylenediaminetetraacetic acid and NaOCl. After drying with paper points the root canals were randomly divided into 5 groups (n = 12), according to filling material: Resilon cones/Real Seal sealer or gutta-percha cones and Endofill, Sealapex, AH Plus or MTA Fillapex sealers. After one week, root canal fillings were removed using Eucaliptol and K-files. Root canals were re-instrumented with K-files and GG burs sized larger than the first ones. The removal of root canal filling material was analyzed by radiography and scanning electron microscopy (SEM). Statistical analysis was performed using Binary Logistic Regression test (P < 0.05). Results: Radiographic and SEM analysis showed that material from the MTA Fillapex group was better removed than that from Endofill, Sealapex, AH Plus and Real Seal groups. Conclusion: After re-instrumentation, MTA Fillapex group showed less remnants into the root canals than Endofill, Sealapex, AH Plus and Real Seal groups. Residual material was most often found in the apical third.Keywords Dental radiography; Endodontic retreatment; Root canal filling materials; Scanning electron microscopy.

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