|Year : 2022 | Volume
| Issue : 1 | Page : 32-35
Dissolving efficacy of xylene on epoxy resin-based and bioceramic-based root canal sealers
Cindy Willie, Aryadi
Department of Conservative Dentistry, Faculty of Dentistry, Trisakti University, Jakarta, Indonesia
|Date of Submission||03-May-2021|
|Date of Decision||27-Jul-2021|
|Date of Acceptance||27-Oct-2021|
|Date of Web Publication||21-Feb-2022|
Department of Conservative Dentistry, Faculty of Dentistry, Trisakti University, Jakarta 11440.
Source of Support: None, Conflict of Interest: None
Background: Epoxy resin-based and bioceramic-based root canal sealers are used in endodontic treatment as root canal obturation materials because they are considered to have many advantages. The complete removal of these materials during root canal retreatment is crucial in order to ensure adequate disinfection. Due to the difficulty in accessing root canal ramifications, removal of these filling materials without damaging the teeth can be successfully achieved using endodontic solvents. Objective: The aim of this study was to evaluate the solubility of two types of root canal sealers in xylene used in endodontics. Methods: A total of 34 epoxy resin and bioceramic samples were stored for 72 h in an incubator to set. The samples were then immersed for 2 min in 1 mL of xylene. The excess xylene on the samples was drained with an absorbent paper and stored in an incubator for 24 h to dry. The pre- and post-immersion weight of the samples was measured using a digital analytical scale, then the weight difference between the groups was analyzed using the independent t test at a 5% significance level. Results: No significant difference was observed between the epoxy resin-based root canal sealer group and the bioceramic-based root canal sealer group (P ≥ 0.05). Conclusion: Xylene endodontic solvent has a similar efficacy for removing epoxy resin-based and bioceramic-based root canal sealers in in vitro study.
Keywords: Bioceramic, epoxy resin, retreatment, root canal sealer, xylene
|How to cite this article:|
Willie C, Aryadi. Dissolving efficacy of xylene on epoxy resin-based and bioceramic-based root canal sealers. Sci Dent J 2022;6:32-5
| Background|| |
Endodontic treatment has a high success rate, ranging from 86% to 93%. Even though the treatment has a high success rate, there are a few factors that could cause failure in the endodontic treatment, such as improper cleaning of the root canals and inadequate obturation., Retreatment of the root canal will be performed if the previous treatment did not fully resolve the problem or completely failed, such as the presence of a periapical lesion and the recurrence of clinical symptoms. Therefore, the aim of retreatment is to eliminate microbial infections and remove previously infected filling materials from the root canal. Two approaches are used in the management of root canal retreatment: surgical and nonsurgical. Nonsurgical retreatment is commonly used because it has a high success rate of up to 99%., Thorough cleaning of the root canal filling materials is needed to enable effective cleaning, shaping, and refilling of the root canal system. Various techniques, such as using hand files and rotary files or a combination of endodontic solvents, can be used to clean endodontic fillings from the root canal.,, According to Stabholz and Friedman, the use of endodontic solvents plays an important role in the process of removing root canal filling materials in dentinal tubules and root ramifications, thus facilitating biomechanical preparation and penetration of irrigation solutions and intracanal medicaments.,
Several types of sealers are used in endodontic treatment, including resin-based, zinc oxide eugenol, calcium hydroxide, mineral trioxide aggregate, and bioceramic-based sealers., Epoxy resin-based sealers are commonly used because they have many advantages; they are opaque to X-rays (radiopaque), they have excellent dimensional stability and low solubility, and they have better adhesion to dentin than zinc oxide eugenol and calcium hydroxide sealers. However, zinc oxide eugenol-based and resin-based sealers have disadvantages; they are easily dissolved in body fluids and they shrink after setting. Therefore, efforts have been made to develop a new endodontic sealer, such as a bioceramic-based sealer, to overcome the disadvantages of previous endodontic sealers.
Due to the difficulty in accessing root canal ramifications, endodontic solvents can be used to successfully remove these filling materials without damaging the teeth. Xylene was reported to be the solvent with the best capacity to dissolve most types of endodontic sealers. Zinc oxide eugenol, calcium hydroxide, and resin-based sealers are reported to be dissolved in xylene, chloroform, eucalyptol essential oils, and orange essential oils. Zinc oxide eugenol, calcium hydroxide, and resin-based sealers are reported to be dissolved in xylene, chloroform, eucalyptol essential oils, and orange essential oils.
Root canal filling materials must be properly removed in endodontic retreatment. Although various techniques have been used to remove these materials, they can still leave a residue in the root canal. Solvents can be used to help remove and reduce the bacteria left in the root canal system. The research study presented in this paper was conducted to evaluate the solubility of two types of root canal sealers, epoxy resin-based, and bioceramic-based sealers, using xylene endodontic solvent.
| Materials and Methods|| |
This experimental laboratory research study was conducted in the laboratory of the Dental Material Testing and Centre of Research (DMT Core), at Trisakti University. Two different root canal sealers were tested in this study: an epoxy resin-based sealer (AH PLUS, LOT: 1905000853, Dentsply, Konstanz, Germany) and a bioceramic-based sealer (Sure-Seal Root, LOT: WR953100, Sure Endo, Seongnam-si, Korea). The solubility of these materials was tested using xylene endodontic solvent (M Dent, Mahidol University, Bangkok, Thailand). A total of 34 epoxy resin-based and bioceramic-based samples (17 samples in each group) were placed into standardized stainless-steel molds with an internal diameter of 8 mm and a height of 1.6 mm. Two standard stainless-steel molds of the same size were used as negative controls for the samples in both groups.
The samples were placed into molds that were prepared above microscopic glass slides. The sealer was placed until the mold was fully filled. Then, the microscopic glass slides were placed at the other side of the mold to create a flat surface. The empty molds were used as negative control samples. All the samples were then placed on a glass plate inside a stainless-steel tray filled with distilled water. The tray was wrapped in plastic to maintain a humid condition, which contains moisture in the air needed for the reaction of the sealer. The resulting samples of each type of cement and the negative controls were left for 72 h stored in an incubator with a temperature of 37°C and moisture to allow the materials to set completely.
After 72 h, the microscopic glass slides were removed from all the samples, and any excess material surrounding the stainless-steel rings was removed and cleaned using a Lecron knife. Then, each mold was weighed in grams up to four decimal places using a digital analytical scale (Fujitsu FS-AR Analytical Balance, Fujitsu, Tokyo, Japan) to obtain their initial weight. Each of the samples was then immersed into 1 mL of xylene for 2 min in each separate 5-mL glass beakers. The excess xylene on the samples was then absorbed with absorbent papers, and the samples were then placed again in the incubators at 37°C for 24 h.,
After 24 h, each sample was weighed again using the same digital analytical scale to obtain the final weight. The difference between the initial weight and the final weight indicated the loss of sealer after immersion in the xylene.
The results were recorded in a Microsoft Excel spreadsheet. The data were tested for normality using the Shapiro–Wilk test and were further analyzed using the independent t test. Statistical analysis was performed using IBM SPSS Statistics for Windows, version 22.0 (IBM, Armonk, New York). The weight difference was analyzed using the independent t test at 5% significance to determine if any significant differences existed between the groups. Statistical significance was determined at P < 0.05.
| Results|| |
The solubility of the epoxy resin-based and bioceramic-based endodontic sealers immersed in xylene endodontic solvents showed that a significant mass loss occurred before and after immersion in the solvent (P ≤ 0.05). No significant difference was observed in the initial weight between the two groups. The mass loss between the sealers in xylene is summarized in [Table 1]. The independent t test results, presented in [Table 2], showed no statistically significant mass loss differences between the epoxy resin-based sealers and the bioceramic-based endodontic sealers (P ≥ 0.05).
|Table 1: Mean value of mass loss and standard deviation (SD) and paired t test of epoxy resin-based sealer and bioceramic-based sealer pre- and post-immersion in xylene solvent|
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|Table 2: Mean value and standard deviation (SD) and independent t test of epoxy resin-based sealer and bioceramic-based sealer|
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| Discussion|| |
The ideal requirements of the root canal sealers used in endodontic treatment should provide an excellent seal, insolubility of body fluids, adequate adhesion with root canal walls, dimensionally stable and biocompatible, and can be easily removed., Many types of root canal sealers are used to create a hermetic seal of the root canals, including epoxy resin-based and bioceramic-based sealers.
Nonsurgical retreatment is a common choice in the management of previous root canal treatment failures. Complete removal of the last obturation material in retreatment is essential to remove the remaining necrotic tissue and bacteria that resulted in the failure of the previous treatment. The mechanical technique used to cleanse the root canal system cannot remove all the obturation materials, such as endodontic sealers, which can enter the ramifications of the root canal., Endodontic solvents are used in retreatment to help clean the obturation material in areas that are difficult to reach with hand files and rotary files.
The empty negative control samples were immersed in xylene for 2 min to ensure that immersing the molds in the solvent did not affect their weight. In this study, it took 72 h to obtain the optimal setting time of the endodontic sealers that were investigated. The setting time of the sealer was confirmed using the help of a clean explorer. The difference in the setting time of the sealers used in this research with that used in previous studies can be due to differences in the size of the mold used in the study.,
Yadav et al. studied the solubility of calcium hydroxide, zinc oxide eugenol, and epoxy resins immersed in xylene solvent for 2 and 10 min. The samples immersed for 10 min experienced a greater mass loss than those that were immersed for 2 min. This proves that the efficacy of xylene solvents is directly proportional to the duration of the sample’s immersion. From the results obtained and described in [Table 2], it can be concluded that the efficacy of xylene in dissolving the two endodontic sealers within 2 min is the same for both types of sealers. The immersion time of the sample in the xylene endodontic solvent used in this study refers to the time used in a previous study, which reported solubility in the epoxy resin-based endodontic sealer after immersion in xylene solvent for 2 min.
In a study conducted by Mushtaq et al., the xylene solvent was reported to effectively dissolve an epoxy resin endodontic sealer. This is in line with the results obtained from this study; xylene solvents can successfully dissolve epoxy resin-based and bioceramic-based sealers within 2 min.
The solubility of the epoxy resin-based sealer, which was caused by the xylene endodontic solvent, is hydrophobic, so it has the ability to penetrate the three-dimensional lattice formed by the polymerization of the sealer. This can cause swelling of the lattice accompanied by a decrease in the strength and hardness of the sealer. The bioceramic-based sealer mechanism of dissolution in the xylene solvent is still unknown, but this study shows that the bioceramic-based sealer is a material that has good potential to be used as a root canal filling material because it showed insignificant differences in solubility in comparison to the epoxy resin-based sealer. This indicates that when retreatment is necessary, bioceramic-based sealers can also be cleaned with the help of xylene endodontic solvents.
Oltra et al. found that the bioceramic-based sealer significantly left more residue than the epoxy resin-based sealer after the sealer was removed with or without chloroform solvents. In this study, the results showed that the xylene solvent could dissolve the epoxy resin-based and bioceramic-based sealers without showing any significant differences in the amount of residue. This is in line with research conducted by Martos et al., which found that xylene solvents are more effective than chloroform solvents. Alzaraikat et al. also reported that xylene solvents could effectively dissolve other endodontic sealers, such as calcium hydroxide-based, silicon-based, and zinc oxide eugenol-based sealers.
| Conclusion|| |
Xylene endodontic solvent has a similar efficacy for removal of epoxy resin-based and bioceramic-based root canal sealers. This shows that xylene solvents have the potential to be the most effective material for dissolving endodontic sealers. However, further research is needed to compare the efficacy of these solvents with other solvents.
Dr. drg. Eko Fibryanto, Sp. K. G. (K), drg. Anastasia Elsa Prahasti, Sp. K. G. (K), and drg. Dewi Liliany Margaretta, M. Kes for giving critics and suggestions for improving this research.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2]