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| Year : 2014 | Volume
: 25
| Issue : 3 | Page : 321-324 |
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| Assessment of coronal leakage of a new temporary light-curing filling material in endodontically treated teeth |
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Aurilene S Cardoso1, Nélida CS Silva1, Juliana M Silva1, Daniel R Herrera2, Aline A Neves3, Emmanuel João Nogueira Leal Silva3
1 Endodontics Department, Federal University of Pará, Belém, PA, Brazil
2 Endodontics Department, Campinas State University, Piracicaba, SP, Brazil
3 Grande Rio University, Rio de Janeiro, RJ, Brazil
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| Date of Submission | 19-Nov-2013 |
| Date of Decision | 10-Dec-2013 |
| Date of Acceptance | 21-May-2014 |
| Date of Web Publication | 7-Aug-2014 |
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 Abstract | | |
Introduction: The aim of this study was to evaluate the sealing ability of a new temporary filling material X-Temp LC (DFL, São Paulo, SP, Brazil) compared with that obtained for Coltosol (Vigodent, Rio de Janeiro, RJ, Brazil) and Vitro Fill (DFL, Rio de Janeiro, RJ, Brazil), using a dye penetration test.
Methods: Standard endodontic access cavities were prepared in 75 human premolars. The teeth were divided into five groups (n = 15 for each group), including a positive (no sealing of access cavity) and a negative control (Filtek Z350 XT, 3M, São Paulo, SP, Brazil). In the experimental groups, the access cavities were sealed with one of the three tested materials. After that, the teeth were immersed in 10% Indian ink for 14 days. The teeth were then rinsed, dried, sectioned in bucco-lingual direction and evaluated under a stereomicroscope using scores for dye penetration. Data were analyzed using Kruskall-Wallis and Student-Newman-Keuls tests (α =0.05).
Results: Positive control sections exhibited complete dye penetration and negative control had no specimen showing marginal leakage. X-Temp LC and Coltosol showed similar results, with no statistical difference between them. Vitro Fill exhibited the highest dye penetration among the experimental groups.
Conclusion: The results of this in vitro study suggest that all temporary restorative materials exhibit some degree of marginal leakage. X-Temp LC and Coltosol, however seal better than Vitro Fill glass ionomer cement. Keywords: Coronal seal, dental leakage, endodontics
How to cite this article:
Cardoso AS, Silva NC, Silva JM, Herrera DR, Neves AA, Leal Silva EN. Assessment of coronal leakage of a new temporary light-curing filling material in endodontically treated teeth. Indian J Dent Res 2014;25:321-4 |
How to cite this URL:
Cardoso AS, Silva NC, Silva JM, Herrera DR, Neves AA, Leal Silva EN. Assessment of coronal leakage of a new temporary light-curing filling material in endodontically treated teeth. Indian J Dent Res [serial online] 2014 [cited 2023 Mar 26];25:321-4. Available from: https://www.ijdr.in/text.asp?2014/25/3/321/138329 |
An appropriate temporary filling material is one of the key factors predicting the success or failure of root canal treatment. These materials seal the tooth temporarily, preventing percolation of fluids, microorganisms and other organic materials from the oral cavity. Reaching periapical tissues, these factors can induce or propagate peri-radicular diseases. [1],[2],[3],[4] Recent studies demonstrated that endodontically treated teeth must receive immediate restoration, because coronal leakage may occur within a few days. [5],[6] Targeting an ideal temporary filling material is therefore an important step during endodontic therapy.
A temporary filling material is considered to be effective when it is able to fulfill certain basic requirements, including: Good sealing of tooth margins; lack of porosity; lack of dimensional changes; good abrasion and compression resistance; easy insertion and removal; compatibility with intracanal medicaments and good aesthetic appearance. [7]
Several materials have been studied in order to determine their ability to seal endodontic access preparations. [8],[9] For instance, some of them exhibit greater resistance to mastication forces, but have a poor cervical sealing ability, or vice versa. Glass ionomer cements have good resistance to chewing forces; however, these materials have poor sealing properties. [10] Conversely, zinc oxide-based materials (i.e. Coltosol, Vigodent, Rio de Janeiro, RJ, Brazil) has adequate sealing properties, but it is not esthetic or durable against mastication forces. [11] The absence of a material fulfilling all the requirements, justifies the search for an ideal temporary filling material.
Of late, a new temporary filling material (X-TEMP LC, DFL, São Paulo, SP, Brazil) was introduced as a light-curing, eugenol-free monocomponent temporary filling cement. In contrast with zinc oxide/eugenol temporary materials, X-TEMP LC does not inhibit the cure process of resin-based restorations and cements. X-TEMP LC is a light-cured material containing 2-hydroxyethyl methacrylate, urethane dimethacrylate, polyethylene, iron oxide, canforquinone, tertiary aliphatic amine, polyacrylic acid and silica. It hardens after 40 s light-curing. It is fast and easy to apply and it is also easy to remove.
The aim of this study was to compare the sealing ability of X-Temp LC with that obtained by an eugenol-free zinc oxide cement (Coltosol) and a glass ionomer cement (Vitro Fill, DFL, Rio de Janeiro, RJ, Brazil). The null hypothesis tested was that there was no significant difference in the sealing ability among the different tested materials.
| Methods | |  |
Ethical clearance was obtained from the Ethical Committee (CEP-ICS/UFPA207/11) of the Federal University of Belém, Parα, Brazil. A total of 75 freshly extracted human premolars were used in this study. The teeth were cleaned of soft tissue and debris before use. Radiographs were taken to confirm the root canal anatomy and the absence of internal abnormalities such as pulp calcification and root resorption.
Standard endodontic access cavities, with approximately 3.5 × 2.5 mm (bucco-lingual × mesiodistal) were performed using a round diamond and EndoZ burs under water cooling. All access cavities were performed by the same operator. A periodontal probe was used to measure the depth of the opening, assuring that it could accommodate 4 mm thickness of the temporary filling material. Gates Glidden and Largo burs were used in the coronal and middle radicular thirds. The working length was established by inserting a 15-K file into each root canal until it was visible at the apical foramen and subtracting 1 mm from this point. The roots were instrumented with a step-back technique and hand-files. The root canals were irrigated with 1% sodium hypochlorite, followed by 5 mL of 17% ethylenediaminetetraacetic acid. The roots were filled using Tagger's Hybrid technique.
The specimens were randomly divided in five groups (three experimental and two control groups), containing 15 teeth each, as described below:
Negative control
The specimens in this group received a composite restoration (Z350 XT) after cavity conditioning with 37% phosphoric acid gel and application of the adhesive material (Prime and Bond NT ® , Dentsply Caulk, Milford, DE, USA).
Positive control
No coronal restoration was performed:
- Group 1: Vitro Fill restoration (DFL);
- Group 2: Coltosol restoration (Vigodent);
- Group 3: X-Temp LC restoration (DFL).
All materials were mixed and handled by the same operator according to the manufacturer's instruction.
The external root surface was completely sealed, except for 2 mm around the access cavities, with a layer of ethyl cyanoacrylate (Superbonder, Loctite Ltda ® , Itapevi, São Paulo, Brazil) and one layer of nail polish in different colors, according to each group: Blue (Group 1), yellow (Group 2), red (Group 3), and green (negative control). Positive control samples were not covered with nail polish.
The teeth were immersed in Indian ink, [12] and stored at 37°C and 100% humidity for 14 days. After that, the samples were washed in running water for 1 h and dried for 12 h at room temperature.
The specimens were sectioned in the bucco-lingual direction with the aid of a diamond disk in at low speed cutting machine (Isomet, Lake Bluff, IL, USA). Both sections were fixed onto glass slides, observed, and photographed under a stereomicroscope at ×25 magnification (model JSZ6S, Opticam, São José dos Pinhais, SP, Brasil). The infiltration degree was assessed according to the scores detailed in [Figure 1]. The greatest depth of dye penetration for each tooth was selected and recorded.
Statistical analyses were performed using the Kruskall-Wallis test, followed by a multiple comparisons test (Student-Newman-Keuls). All analyses were performed at the 5% level of significance.
| Results | | |
The scores of dye penetration for each group are presented in [Table 1] and [Figure 2]. Positive control samples exhibited complete dye penetration (score 3, n = 15), whereas negative control samples had no specimen presenting dye penetration (score 0, n = 15). Group 1 (Vitro Fill samples) exhibited the highest amount of leakage, with eleven specimens showing dye penetration throughout the whole thickness of the temporary restorative material (score 3). These results were, in fact not statistically different from the positive control group. Groups 2 (Coltosol) and 3 (X-Temp LC) showed similar results, with no significant differences between them (P > 0.05), but still showing higher microleakage than the negative control group. | Figure 1: Criteria for evaluation of marginal seal of temporary fillings in dye penetration test
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 | Figure 2: Score distribution of coronal microleakage among four tested groups and the control groups. Groups followed by different superscript letters indicate statistically significant differences (P < 0.05)
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 | Table 1: Score distribution and mean±SD of coronal microleakage among four tested groups and the control groups
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| Discussion | | |
Restoration failures are one of the main factors associated with periapical tissue contamination by microorganisms and fluids from the oral cavity, inducing peri-radicular disease propagation. Microbial penetration in endodontic cavities sealed with temporary filling materials could increase over time, affecting the long-term prognosis of the endodontic therapy. Thus, the time elapsed between root canal filling and final coronal sealing should be minimized. [13],[14]
It has been reported that a minimum of 3.5-4 mm of restorative material is necessary to prevent coronal microleakage. [3],[9] All the research specimens in this study received a thickness of 4 mm of restorative material, except the positive control group (no restoration).
The traditional method to detect microleakage by microscopically evaluating the penetration of a specific tracer after sample section. [15] These tracers include organic dyes (e.g. basic fuchsin, methylene blue, rhodamine B, Indian ink), silver nitrate (AgNO 3 ), radioactive markers, bacterial penetration or by hydrodynamic movements of liquids. [16] It is a well-known fact that most tracers typically have a particle size smaller than the tubule width [17] and the rationale for still using this method is that the penetration of different markers along the interface between the restoration and dental hard tissues in extracted teeth is a surrogate variable for the in vivo penetration of bacteria, fluids and other liquids, which may provoke hypersensitivity, pulpitis, marginal staining or caries. [16] The application of dyes represents the most commonly used method because of its simplicity. Bacterial penetration or penetration of fluids are not widespread tests and moreover, have not yet been validated.
In this study, we assessed and compared the in vitro sealing ability of a new light-curing temporary material (X-Temp LC) to the ones most commonly used in endodontic practice (Vitro Fill and Coltosol). The Indian ink solution was selected as the tracer due to its good visibility, effective penetration, and excellent contrast. [18]
All experimental groups demonstrated some amount of leakage within the restorative material. However, the results indicated a better sealing ability of X-Temp and Coltosol compared with Vitro Fill. In fact, this material showed the higher amount of marginal leakage, with the majority of specimens showing complete marginal leakage along the tooth-filling interface up to the endodontic cavity. Due to the statistical differences among the materials, the null hypothesis in this study was rejected.
The good results obtained for Coltosol-a premixed temporary restorative material-is attributed to its hygroscopic property. Coltosol has a high coefficient of linear expansion, allowing expansion due to water sorption and for this reason, may have adapted more tightly to dentin walls, promoting a good marginal seal. [11] Similar findings were previously demonstrated, indicating that Coltosol is effective against marginal leakage before the final composite restoration. [11]
Vitro Fill - a glass ionomer cement - is one of the most widely used restorative material due to its clinical properties such as adhesion to tooth structure, flexural strength, fluoride release and anticariogenic activity. [19],[20] Nevertheless, in this study, almost all of the Vitro Fill specimens showed some amount of marginal leakage, with scores as high as the positive control group. Our results are in agreement with other studies that show gross marginal leakage with a glass ionomer cement when used as a temporary endodontic restorative material. [10],[11] Some investigations have, however, demonstrated satisfactory results, [19],[21] and we attribute these contradictory results to methodological differences among the studies.
X-Temp LC - a durable light-curing temporary filling material - is a ready to use, easy to place and to remove material, which can be introduced in a single increment of 5 mm thickness without damage to the preparation boundaries. Our findings showed that scores for leakage of X-Temp LC specimens had no statistical difference compared with Coltosol, indicating that both have effective sealing against marginal leakage.
One of the major disadvantages of Coltosol is that, besides the poor resistance to mastication forces, it presents a slow setting reaction which is also dependent on an aqueous environment to initiate. In contrast, X-Temp LC has good resistance to chewing forces and can be light-cured, allowing its insertion in a single increment, reducing the clinical time. In addition, X-Temp LC has a good aesthetic appearance.
The use of resin restorative material has been indicated after endodontic therapy conclusion, because of its excellent sealing properties. In this study, all the negative control specimens, where the nanocomposite was used showed excellent sealing ability, with no specimens showing marginal leakage.
Investigations have confirmed microorganisms and their products are able to go through the whole root canal filling and reach the apical and periapical tissues in few days after endodontic filling, if the coronal restoration is deficient. [5],[13],[22] Therefore, it is important to evaluate the sealing ability of restorative materials, to permit their safe use in endodontic clinical practice.
According to this methodology and to the limitations of this study, all temporary materials showed some degree of marginal leakage. Coltosol and X-Temp LC however, were significantly better in preventing the marginal leakage when compared with Vitro Fill.
| References | | |
| 1. | Ricucci D, Siqueira JF Jr. Recurrent apical periodontitis and late endodontic treatment failure related to coronal leakage: A case report. J Endod 2011;37:1171-5. 
|
| 2. | Siqueira JF Jr, Rôças IN, Alves FR, Campos LC. Periradicular status related to the quality of coronal restorations and root canal fillings in a Brazilian population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100:369-74.
|
| 3. | Weston CH, Barfield RD, Ruby JD, Litaker MS, McNeal SF, Eleazer PD. Comparison of preparation design and material thickness on microbial leakage through Cavit using a tooth model system. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:530-5.
|
| 4. | Williamson AE, Dawson DV, Drake DR, Walton RE, Rivera EM. Effect of root canal filling/sealer systems on apical endotoxin penetration: A coronal leakage evaluation. J Endod 2005;31:599-604.
|
| 5. | Moreno JO, Alves FR, Gonçalves LS, Martinez AM, Rôças IN, Siqueira JF Jr. Periradicular status and quality of root canal fillings and coronal restorations in an urban Colombian population. J Endod 2013;39:600-4.
|
| 6. | Schwartz RS, Robbins JW. Post placement and restoration of endodontically treated teeth: A literature review. J Endod 2004;30:289-301.
|
| 7. | Deveaux E, Hildelbert P, Neut C, Boniface B, Romond C. Bacterial microleakage of Cavit, IRM, and TERM. Oral Surg Oral Med Oral Pathol 1992;74:634-43.
|
| 8. | Lai YY, Pai L, Chen CP. Marginal leakage of different temporary restorations in standardized complex endodontic access preparations. J Endod 2007;33:875-8.
|
| 9. | Zmener O, Banegas G, Pameijer CH. Coronal microleakage of three temporary restorative materials: An in vitro study. J Endod 2004;30:582-4.
|
| 10. | Ciftçi A, Vardarli DA, Sönmez IS. Coronal microleakage of four endodontic temporary restorative materials: An in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:e67-70.
|
| 11. | Zaia AA, Nakagawa R, De Quadros I, Gomes BP, Ferraz CC, Teixeira FB, et al. An in vitro evaluation of four materials as barriers to coronal microleakage in root-filled teeth. Int Endod J 2002;35:729-34.
|
| 12. | Madison S, Swanson K, Chiles SA. An evaluation of coronal microleakage in endodontically treated teeth. Part II. Sealer types. J Endod 1987;13:109-12.
|
| 13. | Estrela C, Leles CR, Hollanda AC, Moura MS, Pécora JD. Prevalence and risk factors of apical periodontitis in endodontically treated teeth in a selected population of Brazilian adults. Braz Dent J 2008;19:34-9.
|
| 14. | Kayahan MB, Malkondu O, Canpolat C, Kaptan F, Bayirli G, Kazazoglu E. Periapical health related to the type of coronal restorations and quality of root canal fillings in a Turkish subpopulation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:e58-62.
|
| 15. | Pashley DH. Clinical considerations of microleakage. J Endod 1990;16:70-7.
[PUBMED] |
| 16. | Heintze SD. Clinical relevance of tests on bond strength, microleakage and marginal adaptation. Dent Mater 2013;29:59-84.
[PUBMED] |
| 17. | Heintze S, Forjanic M, Cavalleri A. Microleakage of Class II restorations with different tracers - Comparison with SEM quantitative analysis. J Adhes Dent 2008;10:259-67.
|
| 18. | Yoshikawa M, Noguchi K, Toda T. Effect of particle sizes in India ink on its use in evaluation of apical seal. J Osaka Dent Univ 1997;31:67-70.
|
| 19. | Singla T, Pandit IK, Srivastava N, Gugnani N, Gupta M. An evaluation of microleakage of various glass ionomer based restorative materials in deciduous and permanent teeth: An in vitro study. Saudi Dent J 2012;24:35-42.
|
| 20. | Virmani S, Tandon S, Rao N. Cuspal fracture resistance and microleakage of glass ionomer cements in primary molars. J Clin Pediatr Dent 1997;22:55-8.
|
| 21. | Madarati A, Rekab MS, Watts DC, Qualtrough A. Time-dependence of coronal seal of temporary materials used in endodontics. Aust Endod J 2008;34:89-93.
|
| 22. | Gillen BM, Looney SW, Gu LS, Loushine BA, Weller RN, Loushine RJ, et al. Impact of the quality of coronal restoration versus the quality of root canal fillings on success of root canal treatment: A systematic review and meta-analysis. J Endod 2011;37:895-902.
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Correspondence Address:
Emmanuel João Nogueira Leal Silva
Grande Rio University, Rio de Janeiro, RJ
Brazil
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0970-9290.138329
[Figure 1], [Figure 2]
[Table 1] |
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