Ivana Milanović

The aim of this study was to evaluate the effect of two laser-assisted disinfection techniques on the porosity and bond strength (BS) of a new premixed calcium silicate sealer. Forty extracted human single-rooted premolars with one root canal were prepared up to 50/05. Samples were randomly assigned to the groups (n = 10 each): 1. shock wave-enhanced emission of photoacoustic streaming (SWEEPS) (20 mJ, 15 Hz, 0.60 W, pulse duration 25 µs), 2. diode laser (975 nm, 1.5 W), 3. conventional needle and syringe irrigation (CI), and 4. control (C), with no final irrigation protocol. Root canals were filled with a premixed calcium silicate sealer using the single-cone obturation technique. Micro-CT scans were performed after two weeks to determine the presence of voids in the filling. Dentinal discs from the middle third were prepared for push-out testing. Kruskal–Wallis and post hoc Dunn tests were used, with significance set at 5%. Micro-CT analysis detected porosity in all samples, with no significant differences among the groups (p > 0.05). SWEEPS showed the highest BS values (median 3.233 MPa) and outperformed CI and C (median 1.923 and 1.989 MPa) (p < 0.05) overall. SWEEPS enhanced the BS compared with CI. Voids were present in all experimental groups.

Introduction/Objective. Aim was to evaluate the push-out bond strength to root canal dentine and radiopacity of three different sealers: Adseal (Meta Biomed Co., Cheongju-si, South Korea), CeraSeal (Meta Biomed Co.) and control AH Plus (Dentsply Sirona, Charlotte, NC, USA). Methods. In nine dentin discs, 1 mm thickness, three holes, 1.2 mm diameter, were drilled in with a fissure carbide bur. Discs were immersed in 0.5% NaOCl and 10% citric acid respectively, for 60 seconds rinsed and dried. Every hole was filled with different sealer. Specimens were wrapped in gauze previously immersed in Hank?s balanced salt solution at 37?C/seven days. The push-out test was performed using universal testing machine at a cross-head speed of 1 mm/min. The radiopacity was tested (ISO 6876/2012 standard). Three sealer specimens, 5 mm in diameter and 2 mm thick were prepared and radiographed using radiovisiography system (CCD sensor, Trophy Radiologie, Marne-la-Vallee, France) with graded aluminum step-wedge. Gray-scale value was assessed using Adobe Photoshop CS7 (Adobe Inc. San Jose, CA, USA). Results. Mean values of push-out bond strength were 5.21 ? 0.87 MPa (Adseal), 0.06 ? 0.02 MPa (CeraSeal), and 3.13 ? 0.38 MPa (AH Plus). A statistically significant difference in push-out bond strength was observed among all three sealer groups (p < 0.05). Adseal exhibited the strongest bond strength to root canal dentine. All sealers achieved radiopacity over 3 mm, with statistically significant difference among the groups (p < 0.05). Conclusion. The epoxy-based sealer Adseal showed higher bond strength compared to AH Plus and calcium silicate-based sealer CeraSeal, which, expectedly, showed the weakest dislocation resistance. All three sealers fulfilled the ISO standard to be distinguished on dental radiogram.

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.

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.

Background/Objectives: Inexperienced dentists and dental students are especially prone to misdiagnosis, and this represents a huge problem regarding antimicrobial stewardship. We aimed to develop a mobile app for rational antibiotic prescribing in dentistry based on local–systemic symptoms and patient factors, rather than solely on diagnosis, to tackle misdiagnosis. Methods: The study involved 64 participants, 50 of which were third-year dental students attending a pharmacology course focusing on antimicrobials, comprising lectures and practical sessions without (noAPP group, n = 22) or with (APP group n = 28) the assistance of a mobile application. The other 14 participants were practicing dentists who decided to register and use the application. All registered users of the application were asked to take a feedback survey, while learning outcomes were evaluated via a pharmacology quiz. Results: A decision tree was used for application development. In total, 76 impressions were collected on the application. The majority of the impressions were related to odontogenic–endodontic infections. Multiple linear regression analysis did not reveal differences in survey responses between practicing dentists and undergraduate students in the feedback survey responses. There was a significant difference in the mean pharmacology test scores between the noAPP and APP groups (5.50 ± 1.80 vs. 7.21 ± 1.03, p = 0.0001). Conclusions: The dentalantibiotic.com application was developed to support rational antibiotic prescribing, in view of tackling misdiagnosis, among inexperienced dentists, as well as to assist in undergraduates’ pharmacology learning, and the current study shows its large impact as an educational tool. The majority of participants considered it easy to use, efficient in facilitating the right antibiotic choice, and useful for everyday decision-making.

Background/Aim: Radiopacity enables radiographic visualization, which is significant in diagnostic procedures and assessment of the quality of endodontic filling. It is important to compare newly developed endodontic sealers with materials that are already in clinical use in order to promote evidence-based dentistry. The aim of our study was to evaluate radiopacity of different calcium silicate-based sealers in comparison with control, epoxy resin-based sealer. The null hypothesis was that there were no statistically significant differences in radiopacity of the tested sealers. Material and Methods: Premixed (TotalFill BC Sealer, EndoSequence BC Sealer, Ceraseal, Bio-C Sealer), two-component (BioRoot RCS, MTA Fillapex, Bioceramic Root Canal Sealer, GuttaFlow Bioseal) calcium silicate-based sealers and AH Plus, as a control, were used. Specimens were radiographed using a Radiovisiography (RVG-4) CCD (charge-coupled devices)-based digital sensor. Results: Ceraseal had the highest, while Bioceramic Root Canal Sealer had the lowest radiopacity. Bioceramic Root Canal Sealer and MTA Fillapex had radiopacity significantly lower than all other sealers. Radiopacity level of AH Plus, was similar to premixed and significantly higher than radiopacities of all two-component endodontic sealers. Conclusions: Calcium silicate-based sealers radiopacity ranged from slightly above minimal required value (3mm), to a value higher than control sealer. Premixed endodontic sealers showed similar radiopacity as AH Plus which suggests that their clinical performance, in terms of visibility on dental radiograms, should be similar

Background: Premixedcalcium silicate-based sealers are ready-to-use, injectable materials with advantageous biological properties that create environment favorable for periapical tissues repair and health. The aim of our study was to examine the radiopacities of premixed calcium silicate-based sealers:TotalFill BCSealer, EndoSequence BC Sealer, Ceraseal, Bio-C Sealer and to compare them with epoxy-basedsealer, AH Plus. Material and methods: Three specimens (2 mm thick and 5 mm in diameter) of each sealer were radiographed using charge-coupled device-baseddigital sensor (Trophy Radiology, Cedex, France) along with an aluminum stepwedge reference.For radiopacity determination, a graph of the logarithm of aluminum thickness versus radiographic density was plotted and a calibration curve was generated. Radiopacities were assessed from the graph and presented as millimeters of aluminum per millimeter of material (mmAl).ANOVA with a post hoc Tukey test was used for statistical analysis and significance was set at 0.05. Results: Radiopacity values of EndoSequence BC Sealer and Bio-C Sealerwere significantly lower than radiopacities of Ceraseal and AH Plus. Differences in values between EndoSequence BC Sealer and Bio-C Sealer as well as between Ceraseal and AH Plus were nonsignificant. TotalFill BC Sealer was nonsignificantly different from all other sealers. Conclusion: Premixed calcium silicate-based endodontic sealers evaluated in our study had radiopacity values higher than 9 mmAl, in ascending order,from Bio-C Sealer, EndoSequence BC Sealer, TotalFill BC Sealer to Ceraseal.