IADR Abstract Archives
Analysis of Endodontic Sealer Dissolution Using an In-vitro Extrusion Model
Objectives: To create a novel in-vitro model simulating a sealer extrusion scenario and examine time-dependent dissolution of endodontic sealers using quantitative 3D surface scanning.
Methods: Fifty acrylic teeth were endodontically treated using standardized protocol involving intentional sealer extrusion. Following endodontic instrumentation, the samples were randomly allocated to one of five sealer groups (n=10): Apexit Plus, AH Plus, BioRoot RCS, TubliSeal EWT, and Gutta Percha (control). The root-filled teeth were immersed for 3 months in polyurethane foam, harboring artificially prepared cavities (mimicking the space around root apex as in a periapical lesion), under flow of a physiologic solution (constant pH and temperature). Blinded 3D surface scans of the teeth were obtained (using a table scanner with specified resolution of ~10μm) at baseline, 1-week, 1-month, and 3-months. Blinded assessment of sealer dissolution was performed by superimposition of the 3D scans using specific software. Sealer dissolution was evaluated by root mean square change from baseline and colour mapping of these dimensional changes. Mixed linear models for repeated measures (controlling for non-independence of observations) along with Bonferroni adjustment for multiple comparisons were used to assess differences in sealer dissolution among groups over all three timepoints (α=0.05).
Results: All sealers groups differed from the control in terms of dimensional changes (P≤0.006). Significant differences in solubility over three months were also observed between AH Plus and Apexit Plus (P=0.003) and between Apexit Plus and TubliSeal EWT (P<0.0001). The greatest sealer loss was observed for Apexit Plus followed by TubliSeal EWT, and initial gain in sealer dimension was observed in BioRoot RCS followed by AH Plus.
Conclusions: This novel in-vitro model reflecting a sealer extrusion scenario combined with 3D surface scanning enables a time-dependent assessment of dissolution of extruded sealers of different types, including hydrophilic materials. Sealer dissolution was highest for Apexit Plus, and highest dimensional gain was noted for BioRoot RCS.
Methods: Fifty acrylic teeth were endodontically treated using standardized protocol involving intentional sealer extrusion. Following endodontic instrumentation, the samples were randomly allocated to one of five sealer groups (n=10): Apexit Plus, AH Plus, BioRoot RCS, TubliSeal EWT, and Gutta Percha (control). The root-filled teeth were immersed for 3 months in polyurethane foam, harboring artificially prepared cavities (mimicking the space around root apex as in a periapical lesion), under flow of a physiologic solution (constant pH and temperature). Blinded 3D surface scans of the teeth were obtained (using a table scanner with specified resolution of ~10μm) at baseline, 1-week, 1-month, and 3-months. Blinded assessment of sealer dissolution was performed by superimposition of the 3D scans using specific software. Sealer dissolution was evaluated by root mean square change from baseline and colour mapping of these dimensional changes. Mixed linear models for repeated measures (controlling for non-independence of observations) along with Bonferroni adjustment for multiple comparisons were used to assess differences in sealer dissolution among groups over all three timepoints (α=0.05).
Results: All sealers groups differed from the control in terms of dimensional changes (P≤0.006). Significant differences in solubility over three months were also observed between AH Plus and Apexit Plus (P=0.003) and between Apexit Plus and TubliSeal EWT (P<0.0001). The greatest sealer loss was observed for Apexit Plus followed by TubliSeal EWT, and initial gain in sealer dimension was observed in BioRoot RCS followed by AH Plus.
Conclusions: This novel in-vitro model reflecting a sealer extrusion scenario combined with 3D surface scanning enables a time-dependent assessment of dissolution of extruded sealers of different types, including hydrophilic materials. Sealer dissolution was highest for Apexit Plus, and highest dimensional gain was noted for BioRoot RCS.