PubMed · 3464606
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R Ogolnik, B Picard. 1986. [Sealing cements. Comparative study].. https://pubmed.ncbi.nlm.nih.gov/3464606/
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The aim of this study was to investigate whether differences in the composition of calcium hydroxide (Ca(OH)2) preparations influence the removal efficiency of irrigation solutions used in combination with filing of the canal. Three Ca(OH)2 preparations were used: Calxyl, Pulpdent paste, and chemically pure Ca(OH)2 mixed with distilled water. Fifty-one single-rooted extracted human teeth were prepared with a step-back technique and divided into groups A, B, and C. In each group, 15 teeth were assigned to each Ca(OH)2 preparation while the remaining two served as positive and negative controls. Each group of treated teeth was divided into three subgroups of five teeth each: subgroup I--canals were irrigated with saline, filed with a #25 file, and finally flushed with saline; subgroup II--canals were irrigated with NaOCl, filed with a #25 file, and finally flushed with NaOCl; and subgroup III--canals were irrigated with NaOCl, filed with a #25 file, and finally flushed with tetrasodium EDTA. Canal sections were then photographed, and the percentage ratios of Ca(OH)2 coated area to the total canal surface area were calculated by image processing analysis. Results revealed: (a) none of the methods efficiently removed all dressing from the walls, and (b) concentration of the paste used had little effect on the efficacy of the methods applied for the removal of the dressing. Excipients (i.e. methylcellulose contained in Pulpdent) possibly effect retention of Ca(OH)2.
The topography of instrumented and uninstrumented canal walls exposed to calcium hydroxide and four different irrigation regimens was observed by scanning electron microscopy. After chemomechanical debridement, one tooth in each matched pair was medicated with calcium hydroxide. One week later, the teeth were irrigated and split longitudinally for evaluation. When no calcium hydroxide was used, predentin and pulpal debris covered the dentinal tubules of the uninstrumented surfaces in specimens irrigated with water or EDTA, but was absent on uninstrumented surfaces in specimens irrigated with NaOCl or NaOCl and EDTA. A typical smear layer was absent in instrumented specimens irrigated with NaOCl and EDTA, but covered the dentinal tubules of the instrumented surfaces of the EDTA irrigated specimens (partially) and the water or NaOCl irrigated specimens (completely). Calcospherites or their remnants were seen on the uninstrumented canal walls of specimens irrigated with NaOCl or NaOCl and EDTA, respectively. Calcium hydroxide use did not alter the surface topography in specimens irrigated with water, EDTA, or NaOCl, but seemed to erode the intertubular dentin in specimens irrigated with NaOCl and EDTA. All irrigants seemed to effectively remove most of the calcium hydroxide.
The aim of this in vitro study was to evaluate the apical seal obtained with three commonly used root canal sealing cements: Sealapex, AH Plus or Topseal, and Sealite, using a new method based on the quantitative analysis of 125I-radiolabeled lysozyme penetration. One hundred thirteen teeth with straight single root canals were instrumented to master apical point #25/30. These were divided into three groups: (i) negative control (4 roots) covered with two layers of nail polish, (ii) test group (105 roots) obturated by laterally condensed guttapercha with the three cements; and (iii) positive control (4 roots) obturated without cement. The groups were then immersed in 125I lysozyme solution for a period of 1, 7, 14, or 28 days. After removal, six sections of 0.8 mm length each were made of each root with a fine diamond wire. Each section was analyzed for activity by a gamma counter, corrected for decay, and used to quantify protein penetration. Leakage was high in the positive control and almost negligible in the negative control. AH Plus (Topseal) and Sealapex showed similar leakage behavior over time, with AH Plus (Topseal) performing better. Sealite showed acceptable leakage up until day 14, after which a large increase occurred, presumably due to three-dimensional instability.