Bioceramic-based root canal sealers are considered to be an advantageous technology in endodontics. The aim of this review was to consider laboratory experiments and clinical studies of these sealers. An extensive search of the endodontic literature was made to identify publications related to bioceramic-based root canal sealers. The outcome of laboratory and clinical studies on the biological and physical properties of bioceramic-based sealers along with comparative studies with other sealers was assessed. Several studies were evaluated covering different properties of bioceramic-based sealers including physical properties, biocompatibility, sealing ability, adhesion, solubility, and antibacterial efficacy. Bioceramic-based sealers were found to be biocompatible and comparable to other commercial sealers. The clinical outcomes associated with the use of bioceramic-based root canal sealers are not established in the literature.

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Bioceramic-Based Root Canal Sealers: A Review

https://www.endoexperience.com/documents/PIIS0099239909008978.pdf

Critical Review on Methacrylate Resin–based Root Canal Sealers

Zhang W, Li Z, Peng B. Ex vivo cytotoxicity of a new calcium silicate–based canal filling material. International Endodontic Journal, 43, 769–774, 2010.



Abstract

Aim  To evaluate the biocompatibility of iRoot SP root canal filling material to L929 mouse fibroblasts.



Methodology  Specimens of iRoot SP, AH Plus and ProRoot mineral trioxide aggregate (MTA) were prepared for direct contact using the Millipore filter diffusion test, as well as extracts in MTT assay. Mouse fibroblasts (L929) were used as toxicity targets. Differences in cytotoxicity between fresh and set specimens and between root canal material extracts were determined by t-test. A P-value <0.05 was considered statistically significant.



Results  In the filter diffusion test, iRoot SP was slightly cytotoxic when tested as a fresh mixture and not cytotoxic in a set condition tested after 24 h. AH Plus was rated moderately cytotoxic when tested as a fresh mixture and slightly cytotoxic in a set (24 h) condition. MTA was noncytotoxic in both a fresh or set state. AH Plus was significantly more toxic than iRoot SP and MTA (P < 0.05). In addition, iRoot SP was significantly more toxic than MTA (P < 0.05). In the MTT assay with set specimens, extracts of iRoot SP and MTA were noncytotoxic, whilst extracts of AH Plus were rated as slightly cytotoxic. AH Plus was significantly more toxic than iRoot SP and MTA (P < 0.05).



Conclusion  AH Plus root canal sealer was significantly more toxic to L-929 cells than MTA and iRoot SP. iRoot SP had intermediate toxicity.

Ex vivo cytotoxicity of a new calcium silicate-based canal filling material.

Vilanova WV, Carvalho-Junior JR, Alfredo E, Sousa-Neto MD, Silva-Sousa YTC. Effect of intracanal irrigants on the bond strength of epoxy resin-based and methacrylate resin-based sealers to root canal walls. International Endodontic Journal, 45, 42–48, 2012.



Abstract

Aim  To assess the bond strength of Epiphany and AH Plus sealers to root canal walls using a push-out test after use of several endodontic irrigants.



Methodology  Roots of 100 maxillary canines were sectioned horizontally 5 mm below the cemento-enamel junction to provide 4-mm-thick dentine disks that were embedded in acrylic resin and had their root canals prepared with a tapered bur (larger diameter = 2.70 mm; smaller diameter = 2.30 mm; length = 4 mm). The specimens were randomly assigned to five groups (n = 20) according to the dentine surface treatment: I – 1% NaOCl (30 min); II – 1% NaOCl (30 min) + 17% EDTA (5 min); III – 17% EDTA (30 min); IV – 24% EDTA gel (30 min); V – 2% chlorhexidine gluconate (CHX) gel (30 min). In each group, two specimens were prepared for scanning electron microscopy to examine the surface of root canal dentine after use of each irrigant. The other 18 specimens were filled with AH plus (n = 9) or Epiphany (n = 9) and subjected to a push-out test in an Instron machine. Data (in MPa) were subjected to statistical analysis by two-way anova and post-hoc Tukey–Kramer test (P < 0.05).



Results  AH Plus had a significantly higher bond strength (8.74 ± 2.75) than Epiphany (6.74 ± 3.97) (P   0.05). One per cent NaOCl was associated with the lowest mean values (3.70 ± 0.86) (P < 0.05). The interaction between surface treatment and sealer revealed significantly higher bond strength for 24% EDTA gel with AH Plus, 2% CHX gel with AH Plus and 1%NaOCl/17%EDTA with Epiphany (P < 0.05).



Conclusion  Except for 1% NaOCl, the removal of smear layer with the other irrigants increased the bond strength of AH Plus to intracanal dentine. The use of 1% NaOCl for 30 min with 17% EDTA as final irrigant for 5 min increased the bond strength of Epiphany.

Jason M. Ames

Papers

Critical Review on Methacrylate Resin–based Root Canal Sealers

Bonding of Self-adhesive (Self-etching) Root Canal Sealers to Radicular Dentin

Contemporary Methacrylate Resin–based Root Canal Sealers Exhibit Different Degrees of Ex Vivo Cytotoxicity When Cured in Their Self-cured Mode