Search Results (41)

Background: This study aimed to evaluate the effect of two shaping systems combined with different irrigant activation methods on the tridimensional distribution of a bioceramic root canal sealer. Methods: Sixty single, round, straight root canals from extracted human teeth were randomized into six groups (n = 10): A1–A3 shaped with RACE NiTi rotary files; B1–B3 shaped with an adaptive XP-Endo Shaper. NaOCl and EDTA irrigation was performed using passive ultrasonic irrigation (PUI, group 1), conventional endodontic needle irrigation (CENI, group 2), or XP-Endo Finisher mechanical activation (group 3). Canals were obturated using the single-cone cold gutta-percha technique with BioRoot RCS bioceramic sealer. Confocal laser scanning microscopy was used to assess sealer penetration (mean and maximum depths and percentage), and sealer integrity on canal walls at coronal, middle, and apical levels. Results: The XP-Endo Shaper combined with the XP-Endo Finisher showed the highest mean sealer penetration depth, while RACE with PUI had the lowest (B3 vs. B2 p = 0.02; vs. A1 p = 0.05). No significant differences were observed in the maximum penetration depth and percentage of penetration across groups. Sealer integrity was significantly lower in the RACE + XP-Endo Finisher group (p < 0.01). Coronal regions consistently showed higher mean and maximum sealer penetration and percentage of penetration compared to apical thirds, with no significant differences in sealer integrity within root regions. Conclusions: The combination of the XP-Endo Shaper and XP-Endo Finisher showed a tendency towards superior sealer tridimensional distribution, particularly in the middle and apical thirds. This in vitro study suggests that adaptive shaping instruments combined with mechanical activation enhance sealer distribution, potentially improving treatment success. Full article

Background/Objectives: The clinical outcome of root canal treatments using calcium silicate-based sealer (CSBS) remains unclear. This study aimed to evaluate the 1-year effect of CSBS in combination with a single-cone obturation technique on periapical lesion (PL) healing evaluated on cone beam computed tomography scans (CBCT) after single-visit root canal retreatment. Methods: This randomized clinical study involved 50 patients with chronic apical periodontitis and previous root canal treatment (ClinicalTrials.gov ID: NCT04072926). The inclusion criteria were previous endodontic treatment, asymptomatic inadequate endodontic treatment, PLs measuring > 5 mm, and percussion and palpation sensitivity. The exclusion criteria were immunocompromised status, pregnancy, periodontally compromised teeth, vertical root fracture, and antibiotic usage in the last month. Single-visit root canal retreatment was performed by the same endodontist. The patients were randomly divided into two groups based on the root canal sealer used: CSBS (BioRoot RCS) and epoxy resin-based sealer (ERBS) (AH Plus). Periapical healing, as the primary outcome measure, was determined according to the reduction in PL volume on CBCT from the preoperative period to the 1-year postoperative period. Results: Pre- and postoperative PL volumes (p > 0.05) were not significantly different between the CSBS and ERBS groups. The success rate (loose criteria) was 82.9% in the ERBS group and 94.7% in CSBS group. Conclusions: Root canal retreatment outcomes of CSBS, including periapical healing, are comparable to those of ERBS at 1 year after the retreatment. Full article

Successful endodontic treatment relies on effective shaping, disinfection and obturation. Calcium silicate sealers such as BioRoot™ RCS show promise due to their bioactivity and sealing properties, but more clinical evidence using standardized protocols is needed. This observational clinical study aimed to assess periapical healing at 6 and 12 months following single-visit root canal treatment using BioRoot™ RCS with hydraulic condensation in teeth with irreversible pulpitis or apical periodontitis. Sixty-six teeth were treated using a standardized protocol: ProTaper Gold instrumentation, sonic-activated irrigation, and hydraulic condensation with gutta-percha cone and BioRoot™ RCS. Periapical healing was evaluated using the periapical index (PAI) at baseline, 6 months, and 12 months. Clinical success was defined as functional, asymptomatic teeth and a PAI ≤ 2. Statistical analysis included repeated measures of ANOVA and McNemar’s test. All 66 teeth remained asymptomatic and functional of 12 months, yielding a 100% survival rate. Clinical success was confirmed in 97% of cases. PAI scores decreased significantly over time (p < 0.001) in apical periodontitis cases. Single-visit endodontic treatment with BioRoot™ RCS and hydraulic condensation demonstrated excellent clinical and radiographic outcomes. This approach promotes resolution of apical periodontitis in non-vital cases and supports the preservation of periapical health in teeth initially diagnosed with irreversible pulpitis. Full article

Rice cultivation has the ability to ameliorate saline soils, but this monoculture pattern can lead to negative plant–soil feedback. In a previous study, we investigated the effects of long-term rice cultivation on saline soil chemistry, salt ions, root characteristics, and agglomerate formation, and concluded that the optimal rice planting period is 5 years. However, we do not know which crop rotation is most effective in improving this negative soil feedback and enhancing soil quality. In this study, we carried out an experiment on saline land planted with rice over 5 years and set up four different rotations, including rice–Hunan Jizi, rice–maize, rice–sweet sorghum, and rice–soybean, with perennial rice planting as CK, to analyze soil texture under different treatments. Physicochemical properties and enzyme activities were also analyzed under different treatments, and the soil quality index (SQI) was constructed using principal component analysis and correlation analysis for comprehensive evaluation of each treatment. The results showed that (1) the saline-alkali soil texture of perennial rice planting in the Yinbei Plain was silty soil, and different rice drought rotation methods changed the soil texture from silty to silty loam, which improved the fractal dimension of the soil. The fractal dimension of saline-alkali soil was significantly positively correlated with the clay volume content, negatively correlated with silt volume content, and negatively correlated with sand volume content. (2) There was no risk of structural degradation (SI > 9%) in saline-alkali soil planted in perennial rice, and it appeared that RS (rice–soybean) could improve the stability coefficient of soil structure in the 0~40 cm soil layer. (3) Different rice and drought rotation methods could significantly affect the physical and chemical properties and enzyme activities of soil, and the quality of soil in the 0~40 cm soil layer was evaluated; RS (rice–soybean) and RC (rice–maize) were suitable for rice drought rotation in the Yinbei area. The structural equation model showed that salinity and soil nutrients were the key factors restricting the improvement of saline-alkali soil quality in Yinbei. These results will deepen the current understanding of bio-modified saline soils. Full article

The adhesion of endodontic sealers to dentin may be influenced both by the chemical composition of the sealer and the final irrigation protocol. The aim of this study was to examine the push-out bond strength of three differently formulated bioceramic sealers to root canal dentin, after different irrigation protocols. Four cavities were prepared in dentine discs obtained from middle thirds of third molars with fused roots. Discs were randomly divided into three groups (n = 8). Group 1: specimens were immersed in 2.5% NaOCl; group 2: in 2.5% NaOCl followed by 17% EDTA; and group 3: in a solution of 2.5% NaOCl with 9% etidronic acid (HEDP). The cavities on each disk were filled with four tested sealers: AH Plus Bioceramic, Bio C Angelus, BioRoot RCS, and AH Plus (n = 8 per sealer). The push-out bond strength test was performed after 7 days. The data were statistically analyzed using two-way analysis of variance with the Bonferroni post hoc test (α = 0.05). Irrigation with NaOCl resulted in significantly lower bond strength values of the sealers in comparison to NaOCl/EDTA and NaOCl/HEDP groups. In the NaOCl and NaOCl/HEDP groups, BioRoot RCS showed similar push-out bond strength compared to AH Plus and significantly higher compared to Bio-C and AH Plus Bioceramic. In the NaOCl/EDTA group, bioceramic sealers achieved a significantly weaker bond strength compared to AH Plus. The bond strength of BioRoot RCS was significantly higher compared to Bio-C and AH Plus Bioceramic. The irrigation protocols and the chemical composition of the sealers significantly influenced their bond strength to dentin. Epoxy resin-based sealer achieved the strongest bond strength, while within bioceramic sealers, the highest values were obtained for BioRoot RCS and the lowest for AH Plus Bioceramic. Full article

The aim of this study is to evaluate the apical sealing ability of novel bioceramic-based (BCB) and widely used resin-based (RB) root canal sealers in combination with traditional or bioceramic-coated gutta-percha points. A total of 92 human single-root extracted teeth were endodontically treated and divided into three groups (A, B, and C) of 30 samples based on the endodontic sealer/type of gutta-percha points/obturation method used. One tooth sample was used for the negative and positive controls (each). Group A: BCB sealer BioRoot RCS (Septodont, Saint-Maur-des-Fossés, France)/bioceramic-impregnated gutta-percha TotalFill BC points (FKG Dentaire, La Chaux-de-Fonds, Switzerland)/cold hydraulic single-cone. Group B: BioRoot RCS (Septodont, France)/traditional Protaper Gold Gutta-Percha Points (Dentsply Sirona, Charlotte, NC, USA)/cold hydraulic single-cone. Group C: RB sealer AdSeal (Meta Biomed, Cheongju, Republic of Korea)/traditional Protaper Gold Gutta-Percha Points (Dentsply Sirona, USA)/warm vertical condensation. A dye penetration method was applied, and the length of apicocoronal penetration was measured using a surgical microscope. The data were statistically analyzed to evaluate differences at the 0.05 significance level. A significant difference was found between groups A and C, p = 0.0003, and groups B and C, p = 0.003. The data analysis proved that the BCB sealer using the cold hydraulic single-cone method ensured a substantially better seal than the RB sealer using the warm vertical condensation method. The choice of the type of gutta-percha points (bioceramic-coated or regular) appeared to be unimportant. No statistical significance was found between groups A and B, which indicates that using bioceramic-coated gutta-percha points does not bring any considerable benefit in view of a no-gap root canal obturation. Full article

Calcium silicate-based sealers (CSBS) vary in chemical composition, which can influence treatment outcomes. Therefore, the study aimed at comparing several commercially available CSBS regarding microstructure and elemental characterization. Four CSBS (AH Plus Bioceramic Sealer, BioRoot RCS, BioRoot Flow, TotalFill BC Sealer) and a control resin-based sealer (AH Plus) were evaluated using scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and X-ray powder diffraction analysis (XRD). The specimens were analyzed after setting (SEM, EDX, XRD), as well as after 7 (SEM) and 28 days (SEM, EDX) of incubation in Hank’s balanced salt solution. AH Plus exhibited a uniform matrix and small amounts of calcium (Ca), significantly decreasing after incubation. In contrast, CSBSs exhibited crystalline forms on the surface and increased Ca content, significantly increasing after 28 days of incubation. The main crystalline phase for all tested CSBS was zirconium oxide, while for ERBS it was calcium tungstate. In conclusion, the amount of calcium increased on the surface of CSBSs after incubation, which alkalinized the pH, promoting mineralization, apatite formation, and antibacterial potential. Despite this, the formation of a hydroxyapatite layer was not demonstrated, possibly due to the high dissolution potential of CSBSs. Full article

Background: The primary objective of this study was to evaluate the cytotoxic and genotoxic effects of calcium silicate-based sealers (BioRoot RCS and MTA Fillapex) compared to an epoxy-based sealer (AH Plus). Materials and methods: The study was conducted in vitro with the cell lines HepG2 and V79 to evaluate cytotoxicity and genotoxicity using the comet and micronucleus assays. Eluates of the materials were tested at two different concentrations (3 cm²/mL and 0.5 cm²/mL) after an exposure time of 72 h. Data were analyzed using the Mann–Whitney and Kruskal–Wallis tests (p < 0.05). Results: At lower concentrations in both cell lines, MTA Fillapex showed no significant difference in the measured comet assay parameters compared to the negative control (p > 0.05). In addition, it showed significantly lower genotoxic effects compared to AH Plus for all comet assay parameters, concentrations, and cell lines (p ≤ 0.001). BioRoot RCS showed lower primary DNA damage (p ≤ 0.001) than AH Plus, only at higher concentrations and in the HepG2 cell line. Concerning the two tested bioceramic sealers, BioRoot RCS showed higher tail intensity values compared to MTA Fillapex (p < 0.05). In contrast to the results of the comet assay, BioRoot RCS significantly reduced the number of nuclear buds and nucleoplasmic bridges in the HepG2 cell line compared to MTA Fillapex, whereas reduction in the V79 cell line was only observed for nuclear buds (p < 0.05). Both materials increased the number of apoptotic cells compared to the negative control (p < 0.05). In comparison to AH Plus, BioRoot RCS and MTA Fillapex significantly reduced the number of cells with micronuclei and increased the number of cells with undamaged chromatin (p < 0.05). Conclusions: The findings suggest that MTA Fillapex and BioRoot RCS exhibit superior biocompatibility over AH Plus, as evidenced by their lower cytotoxic and genotoxic effects in vitro. These results support the use of calcium silicate-based sealers in clinical practice, highlighting the need for further studies to evaluate their performance in vivo and their implications for patient safety. Full article

The calcium silicate-based sealers currently available on the market have different compositions and formulations, which is why their physical and chemical properties may vary. (1) The aim of the study was to measure the physico-chemical properties of calcium silicate-based sealers and their push-out bond strength to root dentine, comparing two push-out testing protocols. (2) Standardized specimens of EndoSequence BC, BioRoot RCS, MTA Fillapex, and AH Plus (control) were subjected to pH measurements over 28 days. Radiopacity was measured using a CCD sensor, and flexural strength was assessed using a three-point bending setup. Push-out bond strength was measured in coronal, middle, and apical sections of 40 single-root teeth (conventional method), and cylindrical cavities were prepared for all sealers on the same root dentine disks in 11 third molars (disk method). (3) EndoSequence BC exhibited a higher pH than MTA Fillapex and the highest radiopacity (p < 0.05). The highest flexural and push-out bond strengths were found for AH Plus. The push-out bond strength of EndoSequence BC and BioRoot RCS was higher than MTA Fillapex (p < 0.05). The conventional and disk methods exhibited similar push-out bond strength results, but the data were more homogeneously distributed in the disk method. (4) All calcium silicate-based sealers exhibited a higher pH than AH Plus. MTA Fillapex did not meet the ISO standard. Calcium silicate-based sealers showed weaker performance in terms of physical properties compared to AH Plus. Full article

Background: Using endodontic sealers with long-term antimicrobial properties can increase the success of endodontic treatment. This study aimed to assess the antimicrobial activity over time of two calcium silicate (CS)-based sealers, AH Plus Bioceramic and BioRoot RCS, and to compare them with an epoxy resin-based sealer, AH Plus Jet, against mature polymicrobial biofilms grown on human radicular dentin. Methods: The antimicrobial activity of the sealers was tested using a direct contact test after 1 and 6 weeks of contact with the biofilms. Cell viability was determined by the adenosine triphosphate (ATP) method and flow cytometry (FC). The results of the ATP test were analyzed using an ANOVA with Welch’s correction, followed by the Games–Howell test. The number of cells with damaged membranes obtained by FC in each period was compared by means of an ANOVA and Duncan’s test. For the comparison between times, a Student’s t-test was used. Results: Globally, after a week of contact, the epoxy resin-based sealer obtained the best results. However, at 6 weeks, the two CSs showed the highest antimicrobial efficacy, with a significant increase in this activity over time. Conclusions: Calcium silicate-based sealers exert long-term antimicrobial activity against endodontic biofilms. Full article

Introduction: We compared the effects of heat on the physicochemical properties of recently developed calcium silicate-based sealers (CSBSs), including BioRoot Flow, BioRoot RCS, and AH Plus Bioceramic sealer, with those of the epoxy-resin-based sealer (ERBS) AH Plus. Methods: The flow, film thickness, setting time, and solubility of sealers were evaluated at 37 °C and 100 °C using ISO 6876/2012. Furthermore, pH and calcium ion release were evaluated at these temperatures. In addition, the mass change in sealers at a high temperature was assessed via thermogravimetric analysis. Then, the chemical composition and components of the sealers were analyzed using a scanning electron microscope and Fourier-transform infrared spectroscopy (FTIR). Results: BioRoot Flow, AH Plus Bioceramic, and AH Plus complied with ISO standards in terms of flow and film thickness, both before and after heat application. However, BioRoot RCS exhibited significantly increased film thickness at 100 °C. The setting times of all sealers were significantly reduced at 100 °C. The solubility of CSBS was >3%, exceeding the ISO 6876/2012 standard, both before and after heat exposure. Conversely, the solubility of AH Plus complied with the standard, regardless of the thermal condition. For 4 weeks, CSBS showed a significantly higher pH than AH Plus at both 37 °C and 100 °C. After heat treatment, calcium release decreased in Bioroot RCS and BioRoot Flow, while AH Plus showed no significant differences before and after treatment. However, CSBS consistently exhibited significantly higher calcium release than AH Plus at both temperatures. An FTIR analysis revealed that the chemical composition of the sealers did not change at the high temperature, whereas a thermogravimetric analysis demonstrated a >5% weight reduction in CSBS and a 0.005% weight reduction in AH Plus at 100 °C. Conclusions: BioRoot Flow, AH Plus Bioceramic, and AH Plus possess favorable physicochemical properties, which make them suitable for application under thermal conditions. At a high temperature, BioRoot RCS did not exhibit changes in its chemical composition. However, its film thickness was increased, and pH and solubility were reduced. Therefore, caution is needed when it is applied at high temperatures, such as during the warm obturation technique. Full article

Hydraulic calcium silicate-based (HCS) sealers have recently gained tremendous popularity due to their unique properties. However, their removal during endodontic retreatment is challenging. The solvent, which could chemically deteriorate the material, would be highly desirable for endodontic retreatment procedures. This preliminary study assessed the interplay and dissolving capability of 10% and 20% citric acid, compared to 17% EDTA, on commonly used HCS sealers (AH Plus Bioceramic Sealer, Bio-C Sealer, BioRoot RCS, TotalFill BC Sealer), and evaluated the potential impact of these solutions on root dentin structure. The interaction between tested sealers and irrigating solutions was photographed, and solubility-related mass changes were determined. The surface morphology of treated filling materials and dentin was evaluated using a scanning electron microscope (SEM). One-way analysis of variance (ANOVA) along with Tukey’s test were used to detect the statistically significant differences among groups at the confidence level of 0.95. Intense gas release was observed during the interaction of HCS materials and citric acid, with no evidently visible “bubbling” after the immersion in EDTA. The mass loss of HCS sealers equally confirmed the significantly higher dissolving characteristics of 10% and 20% citric acid solutions compared to EDTA. The surface structural changes, associated with pore and crack formation, were mainly seen for HCS sealers exposed to citric acid. Meanwhile, no severe erosion was detected for dentin after root canal preparation with 10% and 20% citric acid solutions. These findings demonstrate that citric acid has the potential to dissolve HCS sealers with minimal or no negative impact on root dentin, suggesting citric acid as a solvent for HCS sealers in endodontic retreatment procedures. Full article

Salinity poses a persistent threat to agricultural land, continuously jeopardizing global food security. This study aimed to enhance sweet corn (SC) fitness under varying levels of salinity using indigenous biostimulants (BioS) and to assess their impacts on plant performance and soil quality. The experiment included control (0 mM NaCl), moderate stress (MS; 50 mM NaCl), and severe stress (SS; 100 mM NaCl) conditions. Indigenous biostimulants, including compost (C), Bacillus sp., Bacillus subtilis (R), and a consortium of arbuscular mycorrhizal fungi (A) were applied either individually or in combination. Growth traits, physiological and biochemical parameters in maize plants, and the physico–chemical properties of their associated soils were assessed. SS negatively affected plant growth and soil quality. The RC combination significantly improved plant growth under SS, increasing aerial (238%) and root (220%) dry weights compared to controls. This treatment reduced hydrogen peroxide by 54% and increased peroxidase activity by 46% compared to controls. The indigenous biostimulants, particularly C and R, enhanced soil structure and mineral composition (K and Mg). Soil organic carbon and available phosphorus increased notably in C-treated soils. Furthermore, RC (437%) and CAR (354%) treatments exhibited a significant increase in glomalin content under SS. Indigenous biostimulants offer a promising strategy to mitigate salinity-related threats to agricultural land. They improve plant fitness, fine-tune metabolism, and reduce oxidative stress. In addition, the biostimulants improved the soil structure and mineral composition, highlighting their potential for reconstitution and sustainability in salt-affected areas. This approach holds promise for addressing salinity-related threats to global food security. Full article

We investigated three calcium silicate-based sealers with respect to their chemical characterization, cytotoxicity, and attachment to RAW264.7 cells. BioRoot RCS (BR), Bio-C Sealer (BC), and Sealer Plus BC (SPBC) were assessed using Fourier transform infrared spectroscopy (FTIR), X-ray fluorescence spectroscopy (XRF), and energy-dispersive X-ray spectroscopy (EDX) (n = 4) for elemental characterization, and using scanning electron microscopy (SEM) to evaluate cell morphology and adhesion. Cytotoxicity was determined at different dilutions (1:1, 1:2, and 1:5) using the succinate dehydrogenase activity (MTT assay). Statistical analysis was performed for normal distribution using the Shapiro–Wilk test and for homoscedasticity using Levene’s test, and one-way ANOVA, Tukey’s/Dunnett’s post hoc tests for cell viability and XRF (α = 0.05). Calcium silicate hydrate and calcium hydroxide were detected by FTIR in all groups. EDX detected a higher calcium content for BR and SPBC and aluminum only in the premixed sealers. XRF detected the highest calcium release in BR (p < 0.05). The surface morphology showed irregular precipitates for all the sealers. SPBC at a 1:2 dilution resulted in the lowest cell viability compared to BR (p < 0.05) and BC (p < 0.05). The calcium silicate-based sealers produced a statistically significant reduction in cellular viability at a 1:1 dilution compared to the control group (p < 0.0001). All the sealers maintained viability above 70%. Full article

This investigation aimed to assess, through a systematic review, the effect of non-thermal plasma treatments on root canal sealers’ adhesion to dentin. This study followed the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was undertaken without limits on time or language, until May 2023, in PubMed–MEDLINE, Scopus, Web of Science, OpenGrey, and three endodontic journals. The included studies underwent quality assessment and data extraction. Out of an initial 188 articles, 4 studies were included. Three of these studies based the adhesion ability on the push-out test in human extracted teeth, while the other used bovine dentin samples to measure the contact angle with the sealer (wettability). While there was no consensus about the effect of non-thermal plasma (NTP) on the AH Plus sealer’s adhesion to radicular dentin, NTP seemed to positively influence the adhesion ability of BioRoot RCS and Endosequence BC. The findings of the present review should be interpreted cautiously due to the scarcity of studies on the topic. The NTP parameters should be optimized to obtain a stronger evidence base in endodontics on its role as an adjuvant tool to increase sealers’ adhesion to dentin. Full article