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Experimental method of testing the sealing ability of some materials used for the filling of the root canal systems.

1. INTRODUCTION

The success of the endodontic therapy depends upon the cleaning and debridement of the root canal, but also on the three-dimensional filling which creates the premises of a complete seal of the space formerly occupied by the dental pulp.

Fealing implies preventing the entrance in or the exit from the root canal of any microorganism products and the sealing of the endocanalicular system; furthermore it implies long lasting results in which the material sticks completely to the dentin thanks to the formed chemical bridges. The ideal root-end filling material should be easy to manipulate, radio-opaque, dimensionally stable, non-absorbable and not affected by the presence of moisture. It should also adhere to the preparation walls and seal the root canal system, be non-toxic, well-tolerated by periapical tissues and promote healing (Gartner & Dorn, 1992)

An experiment has been carried out to verify the sealing ability of the materials used in filling the root canals: Zinc Oxide eugenol (IRM), Gutta-flow (Coltene), Apexit (Ivoclar), AH-26 Plus (De Trey-Dentsply, Konstanz, Germany), Forfenan (Septodont) and Seal apex.

2. MATERIAL AND METHODS

32 extracted monoradicular teeth (14 upper cusp, 12 upper incisors and 6 lower cusps) were kept in physiological serum with ampicillin (250 ml serum + 1g Ampicillin) at 38[degrees]. The sectioning above the upper half of the tooth and the canal shaping with Ni-Ti needles or mechanical Protaper was carried out using the same number of moves in the same amount of time. The root canal was cleaned with sodium hypochlorite 2,5%, using the same amount for each tooth. The root canal was dried.

The teeth were divided in 7 groups:

--1st group of 5 teeth were filled using a spiral root canal filler and paste made on place from Zinc Oxide, eugenol (IRM).

--2nd group of 5 teeth were filled using flowable root canal filling material--GuttaFlow (Coltene)

--3nd group of 5 teeth were filled using Apexit (Ivoclar, Vivadent, Schaan, Liechenstein).

--4th group of 5 teeth were filled using Ah26 Plus (De Trey-Dentsply, Konstanz, Germany) powder and liquid mixture with gutta-pecha cones

--5th group of 5 teeth were filled with Forfenan (Septodont)

--6th group of 5 teeth were filled with Sealapex

--2 teeth were kept for control, without root canal filling.

The teeth were kept in moisture for 24 hours.

The exterior of the teeth were isolated with varnish keeping a sector of 1,5 mm near the apex varnish-free. The teeth were then placed in a hammock making sure that their apexes are in contact with the 2% methylene blue for simulating the infiltration at this level. After prepping the teeth, they were kept in moisture at 37[degrees]. The results were verified after 7, 14 and 21 days.

After the impregnation period, the root is sectioned at the 2/3 of the root canal near the crown for assessing the degree of filling at this level. Afterwards, using abrasive metal discs under permanent cooling, 3 cuts are performed in the 1/3 of the root canal near the apex, 2 parallel with the apex and another one perpendicular on the axis, only half of the thickness, at 1-2 mm from the apex. The fragment formed is taken away and the section obtained is examined.

3. RESULTS

The positive control samples showed dye leakage throughout

the length of the canals, while the negative control samples had no dye penetration.

On the control teeth we can observe the infiltration throughout all the root canal system.

We observe a good sealing at AH 26 Plus (GP), but also on the teeth closed with Gutta-flow and sealer (fig. 1).

The results of the study have shown that Ah 26 Plus proved a good sealing compared to IRM, which allowed even a later impregnation.

Forfenan paste has the tendency to seal unequally and because of the distortion phenomenon, may strip off the filling material of the walls of the root canal (fig. 2).

Apexitul and the Sealapex are more efficient when the apex is well sealed and it can be used especially in vital extirpation where they generate the biological healing of the apical segment. The paste with zinc oxide is easy to wash by the fluid from the apical region; the consistency and the quality of the material depend upon the powder-liquid proportion and the addition of iodoform and endomethasone which modify the manipulation time (fig. 3).

[FIGURE 1 OMITTED]

[FIGURE 2 OMITTED]

[FIGURE 3 OMITTED]

4. DISCUTIONS

Three-dimensional sealing of the root canal is one of the main goals of endodontic treatment and is essential for preventing apical and coronal leakage in the root-canal system.

Several test methods have been described to evaluate the sealing quality of obturated root canals. The most popular method is the dye penetration test. Methylene blue dye was used in this study because it easily allows quantitative measurement of the extent of dye penetration by linear measurement techniques (Kersten & Moorer, 1989).

In this study the leakage of six root canal sealers was examined. The materials Apexit and Sealapex are calcium-hydroxide based while the GuttaFlow is a sealer based on polydimetilsiloxane with the addition of powdered guttapercha. IRM (Dentsply Caulk, Milford, DE, USA) is a polymethylmethacrylate-reinforced zinc oxide-eugenol cement indicated for use as a root-end filling material (Harrison & Johnson, 1997) Epoxy resin-based cements have also presented a good performance as root canal sealers. AH Plus (De Trey-Dentsply, Konstanz, Germany) has been shown to have low solubility and disintegration (Versiani et al., 2006) and good adhesion (Sousa-Neto et al., 2005). IRM (Dentsply Caulk, Milford, DE, USA) is a polymethyl methacrylate-reinforced zinc oxide-eugenol cement (Harrison & Johnson, 1997).

This in vitro study was meant to find the material which, independent from the work technique, was capable to seal tight the apex of the endocanalicular system, preventing in ideal work conditions, the apical infiltration.

The results of the study have shown that Ah 26 Plus proved a good sealing compared to IRM, which allowed even a later impregnation.

On the control teeth we can observe the infiltration throughout all the root canal system. The section on the teeth with Gutta flow (Coltene) shows a small infiltration and an airy aspect, proving a good apical sealing, but a poor compactation.

Ah 26 Plus-the section shows a good sealing of the apex and a compact aspect. On the Zinc oxide eugenol sealer we can clearly see the 3-4 mm infiltration on all internal surfaces of the root. On the Forfenan the infiltration was not so significant, but during the cutting it was breaking very easy away from the walls. The volumetric contraction was higher where the material was thicker. On the teeth with lateral compaction (Ah 26 and gutta-percha cones) we observe good sealing and a compact aspect. Sealapex material, although in the first stage the sealing and the aspect were good, after 14 days the leakage modified the compact aspect. Apexit reveals a slight infiltration of 1,5-2 mm between dentin and Apexit, but also between the cone and Apexit.

5. CONCLUSIONS

The experimental study in vitro has many aspects that can generate technical errors, that is why our results are conclusive thanks to the confirmation offered in literature.

To obtain a three-dimensional filling and a correct sealing we must consider the clinical situation from the point of view of the diagnosis, but also keeping in mind the root canal anatomy and the material used. The filling technique of the canal must be well known by the practitioner in accordance with the material used.

The in vivo conditions are different, but by using experimental methods we can discover treatments based on practical results and personal experiences which may lead to maintaining the results over time.

A correct endodontic treatment today is a won battle; a treatment which remains precise in time, without any acute or chronic course is a won war.

6. REFERENCES

Gartner A H.; Dorn S O. (1992):.Advances in endodontic surgery. Dent Clin North Am; 36: 357-379.

Harrison J.W.; Johnson SA(1997) : Excisional wound healing following the use of IRM as a root-end filling material, J Endod.;23:19-27.

Kersten H.W.; Moore W.R. (1989):.Particles and molecules in endodontic leakage. Int Endod J, 22:118-24, ISSN: 0143-2885.

Sousa-Neto, et al (2005): In vitro study of the adhesion of an epoxy based sealer to human dentine submitted to irradiation with Er:YAG and Nd:YAG lasers Int Endod J, 38:866-870, ISSN: 0143-2885 .

Versiani M.A. et al. (2006): A comparative study of physicochemical properties of AH Plus and Epiphany root canal sealants. Int Endod J, 39:464-471,ISSN: 0143-2885.
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Author:Pangica, Anna Maria; Biclesanu, Cornelia; Cherlea, Ion Valeriu; Stanciu, Dana
Publication:Annals of DAAAM & Proceedings
Article Type:Report
Geographic Code:4EUAU
Date:Jan 1, 2009
Words:1421
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