INTRODUCTION: The compatibility of EndoSequence BC Sealer (BC Sealer; Brasseler USA, Savannah, GA) for warm vertical compaction has been questioned due to changing physical properties under higher temperature. The aim was to evaluate the effect of heating on the physical properties (flowability and radiopacity) of a new calcium-based root canal sealer (EndoSequence BC Sealer HiFlow [HiFlow]) in comparison with EndoSequence BC Sealer. METHODS: The flow, and radiopacity of the 2 sealers were measured according to ISO 6786/2012 at different temperatures. Forty real printed plastic teeth (incisor) were used to evaluate the flowability of the two Standard EndoSequence BC Sealer and HiFlow EndoSequence BC Sealer into the lateral and apical accessory canals. These evaluation was done with two obturation techniques including single cone and warm vertical condensation. RESULT: The mean flowability was ranging from 22.25 mm to 9.52 mm. The results indicate that there is a statistical difference between the flowability of the two calcium silicate based sealers under all three different temperatures (37˚C, 100˚C and 150˚C). Radiopacity was measured at two different temperatures including 21˚C and 100˚C. The mean gray value ranged from 213.55 to 202.25. Results showed that HiFlow is more radiopaque and there is a statistically significant difference at both temperatures. The results of single cone and warm vertical obturation techniques show that there is no significant difference between the flowability of the two calcium silicate based sealers into the lateral and apical accessory canals at 21°C and there is a significant difference at higher temperatures. CONCLUSIONS: HiFlow BC sealer had higher flow and was more radiopaque, especially at high temperatures, which are generated by the commonly used warm vertical compaction technique.

The purpose of this study was to compare the density of gutta percha following three different obturation techniques using two split-tooth models. One split-tooth model was constructed with a straight rooted maxillary incisor and the other with the curved palatal root of a maxillary molar. Each tooth was obturated using single cone, cold lateral, and warm vertical obturation techniques without sealer. Each obturation technique was performed 20 times for each of the root systems. The weights of the gutta percha were recorded for each root type and obturation technique by subtracting the post-fill weight from the pre-fill weight of the two split-tooth models. Results show that in the straight canal, the three obturation techniques are significantly different (p < 0.0001). The warm vertical technique had the largest weight of gutta percha, followed by the single cone, and lastly by the cold lateral condensation group. In the curved canal, the three fill types were also significantly different (p < 0.0001). The warm vertical and single cone obturation techniques were not significantly different from one another but were significantly greater in gutta percha weight than the cold lateral technique. In conclusion, within curved canals, warm vertical and single cone techniques were more dense than cold lateral condensation. In the straight canal, the warm vertical was more dense than the single cone which was more dense than the cold lateral technique.

O objetivo deste estudo ex vivo foi avaliar o selamento apical e a resistência de união à dentina radicular da obturação de canais radiculares usando a técnica do cone único dos sistemas WaveOne e Reciproc com diferentes cimentos, em comparação à técnica da condensação lateral. Foram selecionados caninos superiores humanos cujas coroas foram removidas permanecendo as raízes com 15 mm. A amostra foi distribuída aleatoriamente de acordo com o sistema de instrumentação/ técnica de obturação: Reciproc R40/Cone único R40; WaveOne Large/Cone único Large e ProTaper Universal (até instrumento F4)/Condensação lateral. Posteriormente, 9 subgrupos (n=20) foram estruturados conforme o cimento endodôntico: AH Plus, Epiphany SE e MTA Fillapex. Após preparo biomecânico e obturação dos canais radiculares, os espécimes foram armazenados a 37&deg;C e 100% de umidade por período correspondente a três vezes o tempo de endurecimento dos cimentos. O método de filtração de fluidos foi utilizado para verificação do selamento apical em 10 espécimes de cada subgrupo. Espécimes apenas com cone de guta-percha e sem cimento (n=6) e outros completamente impermeabilizados (n=2) foram os controles positivos e negativos, respectivamente. Dos 10 espécimes remanescentes de cada subgrupo foram obtidas fatias de dentina com 1 mm de espessura (3 por terço radicular: cervical, médio e apical), sendo 6 (2 fatias por terço) utilizadas para o teste de push-out. O tipo de falhas ocorridas após a desunião foi avaliado em microscópio óptico (25X de aumento). Dentre as outras fatias, foram selecionadas 5 de cada terço, em cada subgrupo, para análise por microscopia eletrônica de varredura (MEV) (1000X de aumento). Foram mensurados doze pontos na interface material obturador/dentina e os seguintes escores foram atribuídos para a adaptação da obturação: 0 (seções sem lacunas); 1 (seções com pequenas falhas, <1 &mu;m); 2 (seções com muitas lacunas, entre 1 &mu;m e 10 &mu;m) e 3 (sem adaptação, lacunas >10 &mu;m). Os dados de infiltração apical e resistência de união (RU) foram analisados pelo teste ANOVA duas vias e teste de Tukey (p<0,05). Os testes de Kruskal-Wallis e Student-Newman-Keuls (p<0,05) foram utilizados para análise dos dados referentes à adaptação da obturação. Em relação ao selamento apical, as três técnicas apresentaram diferenças entre si, com melhores resultados para a condensação lateral (p<0,05). A técnica WaveOne propiciou menor índice de filtração de fluido que a Reciproc, sem diferença estatisticamente significante entre os cimentos (p>0,05). As técnicas de cone único apresentaram menores valores de RU que a condensação lateral (p<0,05), enquanto nesta última técnica o cimento AH Plus apresentou os maiores valores de RU, sendo estatisticamente superior ao MTA Fillapex e Epiphany SE (p<0,05). Houve predominância de falhas adesivas à dentina no terço apical e mistas nos terços médio e cervical. A análise por MEV mostrou melhor adaptação na interface dentina/material obturador para o cimento AH Plus que para os cimentos MTA Fillapex e Epiphany SE (p<0,05). Concluiu-se que as técnicas de cone único apresentaram maior infiltração apical e menor resistência de união que a condensação lateral. Melhor adaptação marginal foi obtida com o cimento AH Plus, independentemente da técnica de obturação utilizada. / The aim of this ex vivo study was to evaluate the apical sealing and bond strength (BS) of root canal filling using single-cone from WaveOne and Reciproc systems associated to different sealers compared with the lateral condensation technique. The crowns of maxillary human canines were sectioned in order to standardize the root length to 15 mm. The sample was randomly allocated according to instrumentation system /obturation technique: R40 Reciproc file/ R40 single cone; WaveOne Large/Large single cone; ProTaper Universal (up to F4 file)/ Lateral condensation. Subsequently, 9 subgroups (n=20) were defined according to root canal sealer: AH Plus, Epiphany SE and MTA Fillapex. After the preparation and filling procedures, the specimens were stored at 37°C and 100% humidity for a period three times longer than the setting time of the sealers. The fluid filtration method was used to investigate the apical sealing in 10 specimens of each subgroup. Specimens with only cone and without sealer (n=6) and others completely sealed (n=2) were used as positive and negative controls, respectively. Slices with 1 mm thickness (3 per root third: cervical, middle and apical) were obtained from the remaining specimens of each subgroup, while 6 slices (2 per third) were submitted to push-out test. Failures modes were evaluated in optical microscope (magnification 25X). Among the other slices for each experimental condition, five were selected from each third for analysis by scanning electron microscopy (SEM) (magnification 1000X). Twelve points were measured in filling material/dentin interface, and the following scores were used in order to evaluate the root filling adaptation: 0 (sections without gaps); 1 (sections with small gaps, <1&mu;m); 2 (sections with many gaps, between 1 &mu;m and 10 &mu;m) and 3 (without adaptation, gaps>10 &mu;m). The data on apical infiltration and BS were analyzed by two way ANOVA test and Tukey&prime;s test (p<0.05). The Kruskal-Wallis test followed by Student-Newman-Keuls test (p<0.05) were used for data analysis concerning the adaptation of the root filling. Regarding the apical sealing, there was statistical difference between the obturation techniques, whereas the lateral condensation showed the best results (p<0.05). The WaveOne technique provided lower rate of fluid filtration than Reciproc, and no statistically significant differences were observed between the sealers (p>0.05). The single-cone techniques showed lower values of BS than lateral condensation, in which AH Plus showed the highest BS values, with statistical difference from MTA Fillapex and Epiphany SE (p<0.05). There was predominance of adhesive failures in the apical third and mixed failures in the middle and cervical thirds. The SEM analysis revealed better adaptation in the filling material/dentin interface for AH Plus than MTA Fillapex and Epiphany SE. It was concluded that the single-cone techniques resulted in highest apical infiltration and lowest BS than lateral condensation one. Better marginal adaptation was obtained with AH Plus, regardless of obturation technique used.

O objetivo deste estudo ex vivo foi avaliar o selamento apical e a resistência de união à dentina radicular da obturação de canais radiculares usando a técnica do cone único dos sistemas WaveOne e Reciproc com diferentes cimentos, em comparação à técnica da condensação lateral. Foram selecionados caninos superiores humanos cujas coroas foram removidas permanecendo as raízes com 15 mm. A amostra foi distribuída aleatoriamente de acordo com o sistema de instrumentação/ técnica de obturação: Reciproc R40/Cone único R40; WaveOne Large/Cone único Large e ProTaper Universal (até instrumento F4)/Condensação lateral. Posteriormente, 9 subgrupos (n=20) foram estruturados conforme o cimento endodôntico: AH Plus, Epiphany SE e MTA Fillapex. Após preparo biomecânico e obturação dos canais radiculares, os espécimes foram armazenados a 37&deg;C e 100% de umidade por período correspondente a três vezes o tempo de endurecimento dos cimentos. O método de filtração de fluidos foi utilizado para verificação do selamento apical em 10 espécimes de cada subgrupo. Espécimes apenas com cone de guta-percha e sem cimento (n=6) e outros completamente impermeabilizados (n=2) foram os controles positivos e negativos, respectivamente. Dos 10 espécimes remanescentes de cada subgrupo foram obtidas fatias de dentina com 1 mm de espessura (3 por terço radicular: cervical, médio e apical), sendo 6 (2 fatias por terço) utilizadas para o teste de push-out. O tipo de falhas ocorridas após a desunião foi avaliado em microscópio óptico (25X de aumento). Dentre as outras fatias, foram selecionadas 5 de cada terço, em cada subgrupo, para análise por microscopia eletrônica de varredura (MEV) (1000X de aumento). Foram mensurados doze pontos na interface material obturador/dentina e os seguintes escores foram atribuídos para a adaptação da obturação: 0 (seções sem lacunas); 1 (seções com pequenas falhas, <1 &mu;m); 2 (seções com muitas lacunas, entre 1 &mu;m e 10 &mu;m) e 3 (sem adaptação, lacunas >10 &mu;m). Os dados de infiltração apical e resistência de união (RU) foram analisados pelo teste ANOVA duas vias e teste de Tukey (p<0,05). Os testes de Kruskal-Wallis e Student-Newman-Keuls (p<0,05) foram utilizados para análise dos dados referentes à adaptação da obturação. Em relação ao selamento apical, as três técnicas apresentaram diferenças entre si, com melhores resultados para a condensação lateral (p<0,05). A técnica WaveOne propiciou menor índice de filtração de fluido que a Reciproc, sem diferença estatisticamente significante entre os cimentos (p>0,05). As técnicas de cone único apresentaram menores valores de RU que a condensação lateral (p<0,05), enquanto nesta última técnica o cimento AH Plus apresentou os maiores valores de RU, sendo estatisticamente superior ao MTA Fillapex e Epiphany SE (p<0,05). Houve predominância de falhas adesivas à dentina no terço apical e mistas nos terços médio e cervical. A análise por MEV mostrou melhor adaptação na interface dentina/material obturador para o cimento AH Plus que para os cimentos MTA Fillapex e Epiphany SE (p<0,05). Concluiu-se que as técnicas de cone único apresentaram maior infiltração apical e menor resistência de união que a condensação lateral. Melhor adaptação marginal foi obtida com o cimento AH Plus, independentemente da técnica de obturação utilizada. / The aim of this ex vivo study was to evaluate the apical sealing and bond strength (BS) of root canal filling using single-cone from WaveOne and Reciproc systems associated to different sealers compared with the lateral condensation technique. The crowns of maxillary human canines were sectioned in order to standardize the root length to 15 mm. The sample was randomly allocated according to instrumentation system /obturation technique: R40 Reciproc file/ R40 single cone; WaveOne Large/Large single cone; ProTaper Universal (up to F4 file)/ Lateral condensation. Subsequently, 9 subgroups (n=20) were defined according to root canal sealer: AH Plus, Epiphany SE and MTA Fillapex. After the preparation and filling procedures, the specimens were stored at 37°C and 100% humidity for a period three times longer than the setting time of the sealers. The fluid filtration method was used to investigate the apical sealing in 10 specimens of each subgroup. Specimens with only cone and without sealer (n=6) and others completely sealed (n=2) were used as positive and negative controls, respectively. Slices with 1 mm thickness (3 per root third: cervical, middle and apical) were obtained from the remaining specimens of each subgroup, while 6 slices (2 per third) were submitted to push-out test. Failures modes were evaluated in optical microscope (magnification 25X). Among the other slices for each experimental condition, five were selected from each third for analysis by scanning electron microscopy (SEM) (magnification 1000X). Twelve points were measured in filling material/dentin interface, and the following scores were used in order to evaluate the root filling adaptation: 0 (sections without gaps); 1 (sections with small gaps, <1&mu;m); 2 (sections with many gaps, between 1 &mu;m and 10 &mu;m) and 3 (without adaptation, gaps>10 &mu;m). The data on apical infiltration and BS were analyzed by two way ANOVA test and Tukey&prime;s test (p<0.05). The Kruskal-Wallis test followed by Student-Newman-Keuls test (p<0.05) were used for data analysis concerning the adaptation of the root filling. Regarding the apical sealing, there was statistical difference between the obturation techniques, whereas the lateral condensation showed the best results (p<0.05). The WaveOne technique provided lower rate of fluid filtration than Reciproc, and no statistically significant differences were observed between the sealers (p>0.05). The single-cone techniques showed lower values of BS than lateral condensation, in which AH Plus showed the highest BS values, with statistical difference from MTA Fillapex and Epiphany SE (p<0.05). There was predominance of adhesive failures in the apical third and mixed failures in the middle and cervical thirds. The SEM analysis revealed better adaptation in the filling material/dentin interface for AH Plus than MTA Fillapex and Epiphany SE. It was concluded that the single-cone techniques resulted in highest apical infiltration and lowest BS than lateral condensation one. Better marginal adaptation was obtained with AH Plus, regardless of obturation technique used.

Indiana University-Purdue University Indianapolis (IUPUI) / The purpose of this study was to evaluate the fracture resistance of three post and core systems in endodontically treated teeth by loading to failure, and to measure marginal gaps before and after cyclic loading. Sixty extracted canines were assigned to three groups. The groups tested were: 1) Single cast post and core (Group CP). 2) Prefabricated metal post and composite resin core (Group MR). 3) Glass fiber post and composite resin core (Group FR). All teeth were obturated and prepared to receive a post and core with a coping. Thirty teeth (10 from each group) were loaded to failure, and the other 30 teeth were fatigue-loaded. The marginal gaps on the facial and lingual surface of the fatigue-loaded group were measured before and after cyclic loading. There were two hypotheses for this study. The first was that the FR group would have less marginal gap opening on the lingual surface than the other groups. The second was that the CP group would have a higher load at failure than the other groups. Group CP was found to have a significantly smaller pre-loading marginal gap than group FR (p = 0.0265) and group MR (p = 0.0273), while groups FR and MR did not have a significantly different pre-loading marginal gaps (p = 0.86). Group FR had significantly less change in marginal gap than group MR (p = 0.0013). Groups CP and MR did not have significantly different changes in marginal gap (p = 0.09). Groups CP and FR did not have significantly different changes in marginal gap (p = 0.11). The three post types did not have significantly different maximum loads to failure (p= 0.49), moments of inertia at cervical area (p = 0.75), or moments of inertia at fracture site (p=0.12). There was no significant difference between groups CP, FR, and MR in the load-to-failure test. Group CP demonstrated the highest load-to-failure values; however, the highest load-to-failure mean was for group MR. All fractures observed in this study were catastrophic. Group FR demonstrated better stress distribution and caused no early fractures in the fatigue-loading group. All groups demonstrated significant marginal gap changes on the lingual surface after fatigue loading; however, group FR demonstrated <45 μm marginal gap opening. In group FR, the reduced marginal gap opening was attributed to the use of Panavia 21 with the proper surface treatments to bond to the tooth structure, the resin composite, and the metal coping.