Article Options
Categories


Search


Advanced Search



This service is provided on D[e]nt Publishing standard Terms and Conditions. Please read our Privacy Policy. To enquire about a licence to reproduce material from endodonticsjournal.com and/or JofER, click here.
This website is published by D[e]nt Publishing Ltd, Phoenix AZ, US.
D[e]nt Publishing is part of the specialist publishing group Oral Science & Business Media Inc.

Creative Commons License


Recent Articles RSS:
Subscribe to recent articles RSS
or Subscribe to Email.

Blog RSS:
Subscribe to blog RSS
or Subscribe to Email.


Azerbaycan Saytlari

 »  Home  »  Endodontic Articles 12  »  A quantitative evaluation of apical leakage of four root-canal sealers
A quantitative evaluation of apical leakage of four root-canal sealers
Results - Discussion - References.



Results.
The results of the quantitative evaluation of the sealing properties of the four root-canal sealers are shown in Table 2.
All of the sealers gave better seal after 21 days than 7 days (P < 0.05). Sultan showed significantly more leakage when compared to the other sealers at all time periods (P < 0.05). Although RoekoSeal showed better sealing values after 21 days when compared to Ketac-Endo and AH Plus, there was no statistically significant difference (P > 0.05).

Table 2. Microleakage of four sealers used to obturate the root canals.

Microleakage of four sealers used to obturate the root canals

Discussion.
Leakage studies still have a place in evaluating factors involved in root-canal sealing. In this study, an endodontic fluid transport model proposed by Wu et al. (1993) was used to evaluate the sealing ability of root fillings incorporating four different root-canal sealers (AH Plus, RoekoSeal, Ketac-Endo and Sultan). This method has been shown to be more sensitive than dye penetration for the detection of full length voids along root canals and to be highly reproducible (Wu et al. 1993, 1994a). This type of system overcomes some of the disadvantages of previous studies. A major advantage of the method is the ability to measure microleakage without destroying the root specimens. Repeated observation of the same specimens over time to reveal changes in sealing ability is, therefore, possible (Wu et al. 1995, Belli et al. 2001). The model uses positive pressure to help rule out problems caused by entrapped air or fluid which may skew outcomes in dye penetration studies (Goldman et al. 1989). The sensitivity of the system can be adjusted by altering the pressure used and altering the diameter of the micropipette (Fogel 1995).
In order to avoid anatomical variations and to obtain standardization for the leakage measurements in this study, the length of the specimens was kept same. Wu et al. (1993) also advised controlling the length of the samples, canal diameter, and canal anatomy used to reduce the variability of these studies. The use of hand instrumentation and laterally condensed gutta-percha technique was a realistic clinical approach.
A wide variety of root-canal sealers are available commercially, and they are divided into groups according to their chemical composition. There is no consensus on which materials seal most effectively. Sealers based on organic resin (AH Plus), zinc oxide-eugenol (Sultan), glass ionomer (Ketac-Endo) and polyvinylsiloxane (RoekoSeal) were included in our study.
Endodontic sealers based on ZnOE have been used clinically for several decades because they have satisfactory physicochemical properties (Benatti et al. 1978). But in the present study the ZnOE-based sealer (Sultan) showed significantly more leakage when compared to the polydimethylsiloxane (RoekoSeal), glass ionomer (Ketac-Endo), and epoxy resin (AH Plus)-based sealers after 21 days (P < 0.05).
The glass ionomer sealers were introduced into rootcanal treatment because of their adhesion to dental hard tissues (Powis et al. 1982, Aboush & Jenkins 1986). Ketac-Endois specially formulated as a root-canal sealer. In an in vitro study, Kochet al. (1994) demonstrated better sealing with Ketac-Endo than with ZnOE sealer (Grossman’s sealer).Wu et al. (1994b) also found better sealing with Ketac-Endo. On the other hand, Smith & Steiman (1994) and Rohde et al. (1996) observed more leakage with Ketac-Endo than with sealers based on ZnOE. Timpawat & Sripanaratanakul (1998) showed that there is no clear difference between using a ZnOE sealer and Ketac-Endo.
Excellent apical sealing has been found with epoxy resin-based sealers (Grossman1976, Limkangwalmongkol et al.1991). Recently, AHPlus, a sealer based on epoxy resin, was introduced to the market. According to the manufacturer, it has excellent sealing properties without the release of formaldehyde. In an in vitro study, De Almeida et al. (2000) observed that leakage with AHPlus was significantly less than that with the ZnOE sealer (Fill Canal) as well as the glass ionomer sealer (Ketac-Endo). Greater measured leakage for sealers based on ZnOE compared with epoxy resin-based sealers was also found by other authors (Limkangwalmongkol et al.1991, Oguntebi & Shen1992). DeGee et al. (1994) also showed the apical seal of resin-based cements to be superior to that of glass ionomer-based cements.
In this study, statistical analysis showed that all the tested materials showed less leakage after 21 days than 7 days (P < 0.05).
De Gee et al. (1994) and Wuet al. (1994b) indicated that AH26 showed diminished leakage by the time. De Gee et al. (1994) explained this as a result of the slow setting properties of the material. They reported that this property may allow sufficient time for the development of adhesion to dentine but the shrinkage stress may fracture the still weak unset sealer cohesively. On the other hand, the improving seal of Ketac-Endo was explained by the ability of glass ionomer cement to ‘self-repair’ (Davidson & Abdalla 1993). This material expansion (Wiener & Schilder1971) or self-repair may compensate for the volumetric change caused by the setting shrinkage or dissolution of the material (Wu et al.1994b).
RoekoSeal is a recently marketed polydimethylsiloxane- based material. Limited data are available with regard to its sealing or other properties. Bartuskova & Perinka (2001) found that there were no significant differences between the apical leakage of RoekoSeal and AH26. In our study, whenthe1-week results were evaluated, it was noted that root fillings with RoekoSealwere leaking more than others, but after 21 days, the situation was reversed. The slow setting properties of this material could be an explanation for diminished leakage. The clinical significance of these findings is not clear and further studies are needed to clarify the sealing ability of this new material and evaluate its clinical performance.

References.

Aboush YE, Jenkins CB (1986) An evaluation of the bonding   of glass-ionomer restoratives to dentine and enamel. British Dental Journal   161, 179-84.
Bartuskova S, Perinka L (2001) Apical leakage of a new polydimethylsiloxane-   based root-canal sealer. Journal of Dental Research 80(special issue), 741[abstract1717].
Belli S, ZhangY, Pereira PNR, Pashley DH (2001) Adhesive sealing of the pulp   chamber. Journal of Endodontics 27, 521-6.
Benatti O, Stolf WL, Ruhnke LA (1978) Verification of the consistency, setting   time, and dimensional changes of root-canal filling materials. Oral Surgery,   Oral Medicine and Oral Pathology 46, 107-13.
Chailertvanitku lP, Saunders WP, Mackenzie D (1996) An assessment of microbial   coronal leakage in teeth root filled with gutta-percha and three different sealers.   International Endodontic Journal 29, 387-92.
Czonstkowsky M, Michanowicz A, Vazquez JA (1985) Evaluation of an injection   of thermoplasticized low-temperature guttapercha using radioactive isotopes.   Journal of Endodontics 11, 71-4.
Davidson CL, Abdalla AI (1993) Effect of thermal andmechanical load cyclingonthemarginal   integrityof Class II resincomposite restorations. American Journal of Dentistry   6, 39-42.
DeAlmeida WA, Leonardo MR,Tanomaru FM, Silva LAB (2000) Evaluation of apical   sealing of three endodontic sealers. International Endodontic Journal 33,   25-7.
De Gee AJ, Wu MK, Wesselink PR (1994) Sealing properties of Ketac-Endo glass   ionomer cement and AH26 root-canal sealers. International Endodontic Journal   27, 239-44.
Delivanis PD, Chapman KA (1982) Comparison and reliability of techniques   for measuring leakage and marginal penetration. Oral Surgery, Oral Medicine   and Oral Pathology 53, 410-6.
Derkson GD, Pashley DH, Derkson ME (1986) Microleakage measurement of selected   restorative materials: a new in vitro method. Journal of Prosthetic Dentistry   56, 435-40.
Fogel HM (1995) Microleakage of posts used to restore endodontically treated   teeth. Journal of Endodontics 21, 376-9.
Goldman M, Simmonds S, Rush R (1989) The usefulness of dye penetration studies   reexamined. Oral Surgery, Oral Medicine and Oral Pathology 67, 327-32.
Grossman LI (1976) Physical properties of root-canal cements. Journal   of Endodontics 2,166-75.
Haikel Y, Wittenmeyer W, Bateman G, Bentaleb A, Allemann C (1999) A new method   for the quantitative analysis of endodontic microleakage. Journal of Endodontics   25, 172-7.
Kersten HW, tenCate JM, Exterkate RA, Moorer WR, Thodenvan Velzen SK (1988)   A standardized leakage test with curved root canals in artificial dentine.   International Endodontic Journal 21, 191-9.
Koch K, Min PS, Stewart GG (1994) Comparison of apical leakage between Ketac-Endo   sealer and Grossman sealer. Oral Surgery Oral Medicine, and Oral Pathology   78, 784-7.
Larder TC, Prescott AJ, Brayton SM (1976) Gutta-percha: a comparative study   of three methods of obturation. Journal of Endodontics 2, 289-94.
Limkangwalmongkol S, Burtscher P, Abbott PV, Sandler AB, Bishop BM ( 1991) A   comparative study of the apical leakage of four root-canal sealers and laterally   condensed guttapercha. Journal of Endodontics 17, 495-9.
Mannocci F, Innocenti M, Bertelli E, Ferrari M (1999) Dye leakage and SEM   study of roots obturated with Therma ll and dentin bonding agent. Endodontics   and Dental Traumatology 15, 60-4.
Matloff IR, Jensen JR, Singer L, Tabibi A (1982) A comparison of methods   used in root-canal sealibility studies. Oral Surgery, Oral Medicine and   Oral Pathology 53, 203-8.
Miletic I, Anic I, Pezelj-Ribaric S, Jukic S (1999) Leakage of five root-canal   sealers. International Endodontic Journal 32, 415-8.
Nguyen NT (1984) Obturation of the root-canal system. In: Cohen S, Burns   RC, eds. Pathways of the Pulp, 3rd edn. St.Louis: CV Mosby Co, 205-99.
Oguntebi BR, Shen C (1992) Effect of different sealers on thermoplastized   gutta-percha root-canal obturations. Journal of Endodontics 18, 363-6.
Pashley EL,Tao L, Pashley DH (1988) The sealing properties of temporary filling   materials. Journal of Prosthetic Dentistry 60, 292-7.
Powis DR, Folleras T, Merson SA, Wilson AD (1982) Improved adhesion of glass   ionomer cement to dentin and enamel. Journal of Dental Research 6, 1416-22.
Robertson D, Leeb IJ, McKee M, Brewer E (1980) The clearing technique for   the study of root-canal systems. Journal of Endodontics 6, 421-4.
Rohde TR, Bramwell JD, Hutter JW, Roahen JO (1996) An in vitro evaluation   of microleakage of a new root-canal sealer. Journal of Endodontics 22, 365-8.
Smith MA, Steiman HR (1994) An in vitro evaluation of microleakage of two   new and two old root-canal sealers. Journal of Endodontics 20, 18-21.
Starkey DL, Anderson RW, Pashley DH (1993) An evaluation of the effects of   methylene blue dye pH on apical leakage. Journal of Endodontics 19, 435-9.
Timpawat S, Sripanaratanakul S (1998) Apical sealing ability of glass ionomer   sealer with and without smear layer. Journal of Endodontics 24, 343-5.
Wiener BH, Schilder H (1971) A comparative study of important physical properties   of various root-canal sealers. Part II. Evaluation of dimensional changes.   Oral Surgery, Oral Medicine and Oral Pathology 32, 928-37.
Wu MK, Wesselink PR (1993) Endodontic leakage studies reconsidered. Part1.   Methodology, application and relevance. International Endodontic Journal   26, 37-43.
Wu MK, De Gee AJ, Wesselink PR, Moorer WR (1993) Fluid transport and bacterial   penetration along root-canal fillings. International Endodontic Journal   26, 203-8.
Wu MK, DeGee AJ, Wesselink PR (1994a) Fluid transport and dye penetration   along root-canal fillings. International Endodontic Journal 27, 233-8.
Wu MK, De Gee AJ, Wesselink PR (1994b) Leakage of four rootcanal sealers   at different thickness. International Endodontic Journal 27, 304-8.
Wu MK, Wesselink PR, Boersma J (1995) A1-year follow-up study on leakage   of four root-canal sealers at different thickness. International Endodontic   Journal 28, 185-9.