Penetrability of AH plus and MTA fillapex after endodontic treatment and retreatment: A confocal laser scanning microscopy study

Kok, Daniela; Rosa, Ricardo Abreu da; Barreto, Mirela Sangoi; Busanello, Fernanda Hoffmann; Santini, Manuela Favarin; Pereira, Jefferson Ricardo; Só, Marcus Vinícius Reis

doi:10.1002/jemt.22371

Cited by 33 publications

(35 citation statements)

References 26 publications

(36 reference statements)

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“…However, the clinical relevance of the maximum depth of penetration is questioned (20). In addition, the magnification of CLSM used in this research did not allow the analysis of the maximum penetration up to the cement-enamel junction (6). Therefore, to evaluate the influence of CH on sealer penetration in the present study, we measured the percentage of walls where the sealer was present and the percentage of impregnated dentin.…”

Section: Discussionmentioning

confidence: 95%

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Influence of the Calcium Hydroxide Intracanal Dressing on Dentinal Tubule Penetration of Two Root Canal Sealers

Cruz¹,

Grecca²,

Piasecki³

et al. 2017

Eur Endod J

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Objective: The aim of this study was to evaluate the effect of a calcium hydroxide (CH) dressing on the tubular penetration of two endodontic sealers, AH Plus (Dentsply Maillefer, Ballaigues, Switzerland) and MTA Fillapex (Angelus, Londrina, Brazil). Methods: Seventy-two mandibular premolars with a single root canal were prepared with ProFile.04 rotary instruments (Dentsply Maillefer) and divided into four groups. In two groups, an intracanal CH dressing was placed for 15 days. The obturations were performed with lateral condensation of gutta-percha in combination with one of the tested sealers. The roots were transversely sectioned at the apical and middle levels. The percentage of sealer penetration in the root canal walls and the percentage of impregnated dentin area in the transverse sections were obtained using confocal laser scanning microscopy. Statistical analysis was performed using one-way analysis of variance (ANOVA) and Games-Howell test. Results: The CH dressing reduced the mean value of tubular penetration in the middle third of teeth obturated with AH Plus (P<0.01), whereas no difference was observed at the apical sections for both sealers. Conclusion:The CH dressing did not interfere with the apical penetration of both tested sealers, however, decreased the tubular penetration in the middle third of the AH Plus root canal fillings. Overall, MTA Fillapex presented higher tubular penetration than AH Plus obturations. Keywords: Calcium hydroxide, confocal laser scanning microscopy, epoxy resin-based root canal sealer, mineral trioxide aggregate-based sealer

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Section: Discussionmentioning

confidence: 95%

“…None of the currently available methods efficiently removes the CH dressing completely from the canal walls (5). The presence of CH dressing inside the canal may obstruct the dentinal tubules and thereby prevent sealer penetration and affect the apical sealing of the obturation (5,6).…”

Section: Introductionmentioning

confidence: 99%

Influence of the Calcium Hydroxide Intracanal Dressing on Dentinal Tubule Penetration of Two Root Canal Sealers

Cruz¹,

Grecca²,

Piasecki³

et al. 2017

Eur Endod J

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“…Compared with scanning electronic microscopy (SEM), CLSM presents certain advantages, such as a simpler preparation of samples, no need for special specimen processing 23 and analysis of treatment and retreatment using a single sample. 15 In addition, the images obtained by CLSM can be evaluated using a quantitative analysis, contrary to evaluation by scores commonly used in SEM analysis. 24 Rhodamine B and fluorescein dyes were used to contrast the remaining sealer and the new filling sealer after retreatment protocols.…”

Section: Discussionmentioning

confidence: 99%

“…21 The apical third is the area with the greatest anatomical variation, such as accessory canals, isthmus and apical deltas. 15 The present study used the last 6 mm of root canal because this portion has the greatest incidence of isthmus in different anatomical variations. 20 The apical third was divided into three slices of 2 mm to obtain greater representativeness of this region, thereby including three points of the apical third in the statistical analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous analyses have been used in laboratorial studies to assess the remaining filling material, including radiographs, 7 optical microscope, 8,9 scanning electron microscopy, 10 computed tomography 11 and micro-computed tomography. 12,13 Preliminary studies have shown the impact of remaining filling in single root canals after various retreatment protocols 14, 15,16 using confocal laser scanning microscopy (CLSM) analysis; however, the impact on root canals with greater anatomical complexities, such as mesial mandibular molars, has not yet been clarified.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the efficacy of filling material removal and re-filling after different retreatment procedures

et al. 2018

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This study analyzed the influence of different retreatment protocols on amount of remaining filling material and amount of new sealer after endodontic retreatment. Forty mandibular molars with curved mesial roots were prepared with ProTaper Universal system, and filled with AH Plus sealer mixed with 0.1% rhodamine B and gutta-percha. After 7 days, the specimens were randomized according to the retreatment protocol (n = 10): ProTaper Retreatment System (PTR); PTR+Orange Oil (PTR+OO); PTR+Passive Ultrasonic Irrigation (PTR+PUI). No retreatment was performed in the control group (CG). After retreatment, the root canals were filled with AH Plus mixed with 0.1% fluorescein and gutta-percha. Samples were evaluated under confocal laser scanning microscopy and analyzed using Image J software. Data were analyzed using Kruskal-Wallis and Dunn tests (p < 0.05). Regarding presence of residual filling, the Kruskal-Wallis test indicated no differences among the different retreatment techniques in the perimeter and the isthmus analyses (p > 0.05); however, PTR+PUI was associated with a lesser amount of residual filling material in the canal area analysis (p < 0.05). In evaluating the new filling, the perimeter analysis showed a lesser amount of new endodontic sealer in the PTR group (p < 0.05). Moreover, the PTR+PUI group presented a significantly greater amount of new endodontic sealer in the canal area analysis (p < 0.05). There was no difference among groups in the isthmus analysis (p > 0.05). It can be concluded that PTR associated to PUI yielded better results in removing root canal filling material from the canal area. However, none of the protocols resulted in root walls completely free of remnants.

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Microscopic analysis of the quality of obturation and physical properties of MTAFillapex

Amoroso-Silva

Guimarães

Marciano

et al. 2014

Microscopy Res & Technique

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This study analyzed the quality of obturation and physical properties of MTA Fillapex and AH Plus sealer. A sample of 30 human maxillary central incisors were instrumented with Protaper until a F5 (50/05) file. Both sealers were mixed with Rhodamine-B dye to allow visualization on a confocal laser-scanning microscope (CLSM). Next, the canals were filled using the single cone technique. After setting, all samples were sectioned at 2, 4, and 6 mm from the apex. CLSM was used to analyze the gaps and sealer penetration into the dentinal tubules. All samples were scanned 10 µm below the dentin surface and images were recorded at 100× magnification using the fluorescent mode. Additionally, the solubility, flowability and setting time of the sealers were evaluated. All the measured quantities of the examined materials were evaluated for significant differences by means of statistical analysis. The CLSM analysis of the MTA Fillapex showed the highest percentage of gaps at all sections (P = 0.0001). Physical tests revealed adequate properties for both sealers except for a higher solubility of the MTA Fillapex (P = 0.0001). The MTA Fillapex presented flowability and intratubular penetration similar to the AH Plus. Nevertheless, the MTA Fillapex sealer presented a higher solubility and considerable quantity of gaps between the sealer/dentin interface in relation to the AH Plus sealer. Clinicians must take into consideration, the quality of endodontic sealers as it is essential in the outcome of the root canal filling.

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Penetrability of AH plus and MTA fillapex after endodontic treatment and retreatment: A confocal laser scanning microscopy study

Cited by 33 publications

References 26 publications

Influence of the Calcium Hydroxide Intracanal Dressing on Dentinal Tubule Penetration of Two Root Canal Sealers

Influence of the Calcium Hydroxide Intracanal Dressing on Dentinal Tubule Penetration of Two Root Canal Sealers

Evaluation of the efficacy of filling material removal and re-filling after different retreatment procedures

Microscopic analysis of the quality of obturation and physical properties of MTAFillapex

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