journal article·2023-10-29Open access

Clinical Evaluation of a Novel Premixed Tricalcium Silicate Containing Bioceramic Sealer Used with Warm Carrier-Based Technique: A 12-Month Prospective Pilot Study

Andrea Spinelli, Fausto Zamparini, Jacopo Lenzi, Maria Giovanna Gandolfi, Carlo Prati

Applied Sciences· Volume 13· Issue 21

Abstract

Background: This pilot prospective study analysed the clinical use of a new bioceramic premixed CaSi-containing sealer in association with a warm carrier-based technique. Methodology: Healthy patients (n = 38) requiring 40 root canal treatments were enrolled. Periapical X-rays were taken preoperatively, after root canal filling and after 1, 6, and 12 months. Two evaluators assessed the Periapical Index (PAI) and the sealer extrusion. The healing rate and survival rate were also evaluated. Barnard test was used to assess the relationship of each potential prognostic factor with periapical index (PAI) at 12-month follow-up. The significance level was set at 0.05. Results: Root canal treatments (n = 38) were analysed at the end-line (12 months). The total drop-out was 5% (two patients; two teeth). A total of 31 teeth (82%) (PAI 1-2) showed complete healing, while 7 (18%) are still healing. Cumulative survival was 100%. Apical extrusion of the sealers was observed in 18 cases (47%). Of these extrusions, nine (50%) resulted radiographically undetectable after 12 months. Conclusions: The study supports the use of premixed CaSi-based bioceramic sealers in association with carrier-based techniques. Periapical extrusion of the sealer and its radiographic modification or disappearance are possible events reported in the first 12 months.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Endodontics and Root Canal Treatments · Dental Radiography and Imaging · Dental materials and restorations

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Biomedical and Neuromotor Sciences, Endodontic Clinical Section, Dental School, University of Bologna, 40125 Bologna, Italy

Laboratory of Green Biomaterials and Oral Pathology, Department of Biomedical and Neuromotor Sciences, Dental School, University of Bologna, 40125 Bologna, Italy

Department of Biomedical and Neuromotor Sciences, Hygiene, Public Health and Medical Statistics Section, Alma Mater Studiorum, University of Bologna, 40125 Bologna, Italy

References (47)

Show source-provided references
1. Technique acquisition in the use of two thermoplasticized root filling methods by inexperienced dental students: A micro-CT analysis10.1016/j.joen.2009.07.027 ↗
2. The fate of root canals obturated with Thermafil: 10-year data for patients treated in a master program10.1007/s00784-018-2756-8 ↗
3. Comparative analysis of carrier-based obturation and lateral compaction: A retrospective clinical outcomes study10.1155/2012/954675 ↗
4. A prospective randomized comparative study of cold lateral condensation versus Core/Gutta-percha in teeth with periapical lesions10.1016/j.joen.2015.10.022 ↗
5. Physical properties of 5 root canal sealers10.1016/j.joen.2013.06.012 ↗
6. Use of calcium-containing endodontic sealers as apical barrier in fluid-contaminated wide-open apices
7. Mineral trioxide aggregate as apical plug in teeth with necrotic pulp and immature apices: A 10-year case series10.1016/j.joen.2013.12.007 ↗
8. Cytocompatibility and bioactive potential of AH Plus Bioceramic Sealer: An in vitro study10.1111/iej.13805 ↗
9. Clinical Outcome of Non-Surgical Root Canal Treatment Using a Single-cone Technique with Endosequence Bioceramic Sealer: A Retrospective Analysis10.1016/j.joen.2018.02.019 ↗
10. Filling ability of three variants of the single-cone technique with bioceramic sealer: A micro-computed tomography study10.1007/s10856-020-06443-0 ↗
11. Calcium silicate bioactive cements: Biological perspectives and clinical applications10.1016/j.dental.2015.01.004 ↗
12. New Portland cement-based materials for endodontics mixed with articaine solution: A study of cellular response10.1016/j.joen.2007.09.001 ↗
13. Calcium silicate and calcium hydroxide materials for pulp capping: Biointeractivity, porosity, solubility and bioactivity of current formulations
14. Environmental scanning electron microscopy connected with energy dispersive x-ray analysis and Raman techniques to study ProRoot mineral trioxide aggregate and calcium silicate cements in wet conditions and in real time10.1016/j.joen.2009.12.007 ↗
15. Ion release, porosity, solubility, and bioactivity of MTA Plus tricalcium silicate10.1016/j.joen.2014.03.025 ↗
16. Bioactive tri/dicalcium silicate cements for treatment of pulpal and periapical tissues10.1016/j.actbio.2019.05.050 ↗
17. Calcium silicate and calcium aluminate cements for dentistry reviewed10.1111/jace.18051 ↗
18. Present status and future directions: Hydraulic materials for endodontic use10.1111/iej.13709 ↗
19. Zamparini, F., Prati, C., Taddei, P., Spinelli, A., Di Foggia, M., and Gandolfi, M.G. (2022). Chemical-Physical Properties and Bioactivity of New Premixed Calcium Silicate-Bioceramic Root Canal Sealers. Int. J. Mol. Sci., 23.10.3390/ijms232213914 ↗
20. Physicochemical and Biological Properties of AH Plus Bioceramic10.1016/j.joen.2022.10.009 ↗
21. Donnermeyer, D., Schemkämper, P., Bürklein, S., and Schäfer, E. (2022). Short and Long-Term Solubility, Alkalizing Effect, and Thermal Persistence of Premixed Calcium Silicate-Based Sealers: AH Plus Bioceramic Sealer vs. Total Fill BC Sealer. Materials, 15.10.3390/ma15207320 ↗
22. Zavattini, A., Knight, A., Foschi, F., and Mannocci, F. (2020). Outcome of root canal treatments using a new calcium silicate root canal sealer: A non-randomized clinical trial. J. Clin. Med., 9.10.3390/jcm9030782 ↗
23. Zamparini, F., Spinelli, A., Cardinali, F., Ausiello, P., Gandolfi, M.G., and Prati, C. (2023). The Use of Premixed Calcium Silicate Bioceramic Sealer with Warm Carrier-Based Technique: A 2-Year Study for Patients Treated in a Master Program. J. Funct. Biomater., 14.10.3390/jfb14030164 ↗
24. Pontoriero, D.I.K., Ferrari Cagidiaco, E., Maccagnola, V., Manfredini, D., and Ferrari, M. (2023). Outcomes of Endodontic-Treated Teeth Obturated with Bioceramic Sealers in Combination with Warm Gutta-Percha Obturation Techniques: A Prospective Clinical Study. J. Clin. Med., 12.10.3390/jcm12082867 ↗
25. World Medical Association (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. J. Am. Med. Assoc., 310, 2191–2194.10.1001/jama.2013.281053 ↗
26. STROBE Initiative Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and elaboration10.1097/EDE.0b013e3181577511 ↗
27. A guide for preparing a patient-oriented research manuscript10.1016/j.tripleo.2007.01.021 ↗
28. The periapical index: A scoring system for radiographic assessment of apical periodontitis10.1111/j.1600-9657.1986.tb00119.x ↗
29. Assessment of Extrusion and Postoperative Pain of a Bioceramic and Resin-Based Root Canal Sealer10.1055/s-0039-3399457 ↗
30. A new test for 2 × 2 tables10.1038/156177a0 ↗
31. Recommended tests for association in 2 × 2 tables10.1002/sim.3531 ↗
32. Interval estimation for a binomial proportion10.1214/ss/1009213286 ↗
33. Calhoun, P. (2023, October 18). Exact: Unconditional Exact Test. R Package Version 3.2, 2022. Available online: https://CRAN.R-project.org/package=Exact.
34. Real-time Intracanal Temperature Measurement during Different Obturation Techniques10.1016/j.joen.2018.08.013 ↗
35. European Society of Endodontology (2006). Quality guidelines for endodontic treatment: Consensus report of the European Society of Endodontology. Int. Endod. J., 39, 921–930.10.1111/j.1365-2591.2006.01180.x ↗
36. Apically Extruded Sealers: Fate and Influence on Treatment Outcome10.1016/j.joen.2015.11.020 ↗
37. The Effect of Unintentional AH-Plus Sealer Extrusion on Resolution of Apical Periodontitis After Root Canal Treatment and Retreatment-A Retrospective Case-control Study10.1016/j.joen.2023.07.021 ↗
38. The impact of sealer extrusion on endodontic outcome: A systematic review with meta-analysis10.1111/aej.12370 ↗
39. Osteoinductive potential and bone-bonding ability of ProRoot MTA, MTA Plus and Biodentine in rabbit intramedullary model: Microchemical characterization and histological analysis10.1016/j.dental.2017.01.017 ↗
40. Biological aspects of root canal filling materials--histocompatibility, cytotoxicity, and mutagenicity10.1007/s007840050002 ↗
41. Mineral Trioxide Aggregate (MTA) a success story in apical surgery
42. Comparative Biocompatibility and Osteogenic Potential of Two Bioceramic Sealers10.1016/j.joen.2018.08.007 ↗
43. Calcium phosphate phase transformation produced by the interaction of the portland cement component of white mineral trioxide aggregate with a phosphate-containing fluid10.1016/j.joen.2007.07.008 ↗
44. Guided tissue remineralisation of partially demineralised human dentine10.1016/j.biomaterials.2007.11.001 ↗
45. Mekhdieva, E., Del Fabbro, M., Alovisi, M., Comba, A., Scotti, N., Tumedei, M., Carossa, M., Berutti, E., and Pasqualini, D. (2021). Postoperative Pain following Root Canal Filling with Bioceramic vs. Traditional Filling Techniques: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J. Clin. Med., 10.10.3390/jcm10194509 ↗
46. Comparison of Postobturation Pain Experience after Apical Extrusion of Calcium Silicate- and Resin-Based Root Canal Sealers10.1016/j.joen.2021.05.008 ↗
47. Endodontic Microbial Communities in Apical Periodontitis10.1016/j.joen.2022.11.015 ↗