Evaluation of Dentin Adaptability of Fluoride Varnish as a Root Canal Sealer Using Scanning Electron Microscopy
Abstract
Objectives: This study aimed to assess the dentin adaptability of a certain type of fluoride varnish, as a novel root canal sealer, in comparison with AH-Plus sealer.
Materials and Methods: Twenty-four extracted single-rooted, single-canal human permanent teeth with straight and fully formed roots and no internal calcification, resorption or cracks, were selected and decoronated such that the remaining root length was 14 mm in all teeth. Root canals were prepared using the Mtwo rotary file system according to the manufacturer's instructions and filled with gutta-percha and either AH-Plus (n=12) or fluoride varnish (n=12) via the lateral compaction technique. Each root was then sectioned at 4 and 8 mm distances from the apex for evaluation under a scanning electron microscope (SEM). The gap size between the sealer and dentin was measured. Statistical analysis was performed using the Kolmogorov-Smirnov test and t-test with the significance level set at 0.05.
Results: The mean gap size was 14.407±1.402 µm and 8.342±0.694 µm in the roots obturated with AH-Plus and fluoride varnish sealers, respectively. The t-test revealed a statistically significant difference (P<0.001) in this regard between the two groups.
Conclusion: Fluoride varnish, as a root canal sealer, has a superior adaptation to dentinal canal walls compared to the AH-Plus sealer.
1. Sjogren U, Figdor D, Persson S, Sundqvist G. Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endod J. 1997 Sep;30(5):297-306.
2. Li GH, Niu LN, Zhang W, Olsen M, De-Deus G, Eid AA, et al. Ability of new obturation materials to improve the seal of the root canal system: a review. Acta Biomater. 2014 Mar;10(3):1050-1063.
3. ØRSTAVIK D. Materials used for root canal obturation: technical, biological and clinical testing. Endod Topics. 2005 Nov;12(1):25-38.
4. Grossman LI, Oliet S, Del Rio CE. Endodontic Practice. Lea & Febiger, Philadelphia, PA, USA, 1988:179-227.
5. Tyagi S, Mishra P, Tyagi P. Evolution of root canal sealers: An insight story. Eur J Gen Dent. 2013 Aug;2(3):199-218.
6. Sevimay S, Dalat D. Evaluation of penetration and adaptation of three different sealers: a SEM study. J Oral Rehabil. 2003 Sep;30(9):951-5.
7. Agouropoulos A, Twetman S, Pandis N, Kavvadia K, Papagiannoulis L. Caries-preventive effectiveness of fluoride varnish as adjunct to oral health promotion and supervised tooth brushing in preschool children: a double-blind randomized controlled trial. J Dent. 2014 Oct;42(10):1277-83.
8. Fontana M, Gonzalez-Cabezas C, Haider A, Stookey GK. Inhibition of secondary caries lesion progression using fluoride varnish. Caries Res. 2002 Mar-Apr;36(2):129-35.
9. Omidi S, Iomee M, Eshaghi F, Ahanjan M, Cherati JY. Antibacterial effect of stannous fluoride (SnF) 0.63% as an intracanal medicament against Enterococcus faecalis: An in vitro study. Ann Dent Spec. 2018 Jan-Mar:6(1):35-39.
10 Lochaiwatana Y, Poolthong S, Hirata I, Okazaki M, Swasdison S, Vongsavan N. The synthesis and characterization of a novel potassium chloride-fluoridated hydroxyapatite varnish for treating dentin hypersensitivity. Dent Mater J. 2015;34(1):31-40.
11. Chawla HS, Setia S, Gupta N, Gauba K, Goyal A. Evaluation of a mixture of zinc oxide, calcium hydroxide, and sodium fluoride as a new root canal filling material for primary teeth. J Indian Soc Pedod Prev Dent. 2008 Jun;26(2):53-8.
12. Ritter AV, de L Dias W, Miguez P, Caplan DJ, Swift EJ Jr. Treating cervical dentin hypersensitivity with fluoride varnish: a randomized clinical study. J Am Dent Assoc. 2006 Jul;137(7):1013-20; quiz 1029.
13. Parirokh M, Talebizad M, Forghani FR, Haghdoost AA, Asgary S, Eghbal MJ, et al. Fluoride varnish as root canal sealer: a scanning electron microscopy and bacterial penetration study. Iran Endod J. 2015 Winter;10(1):64-8.
14. Rao DG, Trivedi MV, Havale R, Shrutha SP. New fluoride MI Varnish as root canal sealer: An in vitro analysis of bacterial leakage. J Indian Soc Pedod Prev Dent. 2016 Oct-Dec;34(4):359-63.
15. Olympio KP, Cardoso VE, Bijella MF, Pessan JP, Delbem AC, Buzalaf MA. Urinary fluoride output in children following the use of a dual-fluoride varnish formulation. J Appl Oral Sci. 2009 May-Jun;17(3):179-83.
16. Moradi S, Ghoddusi J, Forghani M. Evaluation of dentinal tubule penetration after the use of dentin bonding agent as a root canal sealer. J Endod. 2009 Nov;35(11):1563-6.
17. Silva EJ, Perez R, Valentim RM, Belladonna FG, De-Deus GA, Lima IC, et al. Dissolution, dislocation and dimensional changes of endodontic sealers after a solubility challenge: a micro-CT approach. Int Endod J. 2017 Apr;50(4):407-14.
18. Mohammadian F, Farahanimastary F, Dibaji F, Kharazifard MJ. Scanning Electron Microscopic Evaluation of the Sealer-Dentine Interface of Three Sealers. Iran Endod J. 2017 Winter;12(1):38-42.
19. Forough Reyhani M, Ghasemi N, Rahimi S, Salem Milani A, Mokhtari H, Shakouie S, et al. Push-Out Bond Strength of Dorifill, Epiphany and MTA-Fillapex Sealers to Root Canal Dentin with and without Smear Layer. Iran Endod J. 2014 Fall;9(4):246-50.
20. Carvalho CN, Martinelli JR, Bauer J, Haapasalo M, Shen Y, Bradaschia-Correa V, et al. Micropush-out dentine bond strength of a new gutta-percha and niobium phosphate glass composite. Int Endod J. 2015 May;48(5):451-9.
21. Balguerie E, van der Sluis L, Vallaeys K, Gurgel-Georgelin M, Diemer F. Sealer penetration and adaptation in the dentinal tubules: a scanning electron microscopic study. J Endod. 2011 Nov;37(11):1576-9.
22. Shokouhinejad N, Sabeti M, Gorjestani H, Saghiri MA, Lotfi M, Hoseini A. Penetration of Epiphany, Epiphany self-etch, and AH Plus into dentinal tubules: a scanning electron microscopy study. J Endod. 2011 Sep;37(9):1316-9.
23. Vassiliadis LP, Sklavounos SA, Stavrianos CK. Depth of penetration and appearance of Grossman sealer in the dentinal tubules: an in vivo study. J Endod. 1994
Aug;20(8):373-6.
24. Mamootil K, Messer HH. Penetration of dentinal tubules by endodontic sealer cements in extracted teeth and in vivo. Int Endod J. 2007 Nov;40(11):873-81.
25. Steier L, de Figueiredo JAP, Belli S. Comparison of the interface dentin-endodontic sealer using two SEM magnifications. Rev Odonto Ciênc. 2010 Dec;25(3):296-9.
26. Grossman LI, Shepard LI, Pearson LA. Roentgenologic and clinical evaluation of endodontically treated teeth. Oral Surg Oral Med Oral Pathol. 1964 Mar;17:368-74.
27. Barbizam JV, Trope M, Tanomaru-Filho M, Teixeira EC, Teixeira FB. Bond strength of different endodontic sealers to dentin: push-out test. J Appl Oral Sci. 2011 Nov-Dec;19(6):644-7.
28. Sagsen B, Ustun Y, Demirbuga S, Pala K. Push-out bond strength of two new calcium silicate-based endodontic sealers to root canal dentine. Int Endod J. 2011 Dec;44(12):1088-91.
29. Marciano MA, Guimaraes BM, Ordinola-Zapata R, Bramante CM, Cavenago BC, Garcia RB, et al. Physical properties and interfacial adaptation of three epoxy resin-based sealers. J Endod. 2011 Oct;37(10):1417-21.
30. Wu MK, de Gee AJ, Wesselink PR. Effect of tubule orientation in the cavity wall on the seal of dental filling materials: an in vitro study. Int Endod J. 1998 Sep;31(5):326-32.
31. Sen BH, Büyükyilmaz T. The effect of 4% titanium tetrafluoride solution on root canal walls--a preliminary investigation. J Endod. 1998 Apr;24(4):239-43.
2. Li GH, Niu LN, Zhang W, Olsen M, De-Deus G, Eid AA, et al. Ability of new obturation materials to improve the seal of the root canal system: a review. Acta Biomater. 2014 Mar;10(3):1050-1063.
3. ØRSTAVIK D. Materials used for root canal obturation: technical, biological and clinical testing. Endod Topics. 2005 Nov;12(1):25-38.
4. Grossman LI, Oliet S, Del Rio CE. Endodontic Practice. Lea & Febiger, Philadelphia, PA, USA, 1988:179-227.
5. Tyagi S, Mishra P, Tyagi P. Evolution of root canal sealers: An insight story. Eur J Gen Dent. 2013 Aug;2(3):199-218.
6. Sevimay S, Dalat D. Evaluation of penetration and adaptation of three different sealers: a SEM study. J Oral Rehabil. 2003 Sep;30(9):951-5.
7. Agouropoulos A, Twetman S, Pandis N, Kavvadia K, Papagiannoulis L. Caries-preventive effectiveness of fluoride varnish as adjunct to oral health promotion and supervised tooth brushing in preschool children: a double-blind randomized controlled trial. J Dent. 2014 Oct;42(10):1277-83.
8. Fontana M, Gonzalez-Cabezas C, Haider A, Stookey GK. Inhibition of secondary caries lesion progression using fluoride varnish. Caries Res. 2002 Mar-Apr;36(2):129-35.
9. Omidi S, Iomee M, Eshaghi F, Ahanjan M, Cherati JY. Antibacterial effect of stannous fluoride (SnF) 0.63% as an intracanal medicament against Enterococcus faecalis: An in vitro study. Ann Dent Spec. 2018 Jan-Mar:6(1):35-39.
10 Lochaiwatana Y, Poolthong S, Hirata I, Okazaki M, Swasdison S, Vongsavan N. The synthesis and characterization of a novel potassium chloride-fluoridated hydroxyapatite varnish for treating dentin hypersensitivity. Dent Mater J. 2015;34(1):31-40.
11. Chawla HS, Setia S, Gupta N, Gauba K, Goyal A. Evaluation of a mixture of zinc oxide, calcium hydroxide, and sodium fluoride as a new root canal filling material for primary teeth. J Indian Soc Pedod Prev Dent. 2008 Jun;26(2):53-8.
12. Ritter AV, de L Dias W, Miguez P, Caplan DJ, Swift EJ Jr. Treating cervical dentin hypersensitivity with fluoride varnish: a randomized clinical study. J Am Dent Assoc. 2006 Jul;137(7):1013-20; quiz 1029.
13. Parirokh M, Talebizad M, Forghani FR, Haghdoost AA, Asgary S, Eghbal MJ, et al. Fluoride varnish as root canal sealer: a scanning electron microscopy and bacterial penetration study. Iran Endod J. 2015 Winter;10(1):64-8.
14. Rao DG, Trivedi MV, Havale R, Shrutha SP. New fluoride MI Varnish as root canal sealer: An in vitro analysis of bacterial leakage. J Indian Soc Pedod Prev Dent. 2016 Oct-Dec;34(4):359-63.
15. Olympio KP, Cardoso VE, Bijella MF, Pessan JP, Delbem AC, Buzalaf MA. Urinary fluoride output in children following the use of a dual-fluoride varnish formulation. J Appl Oral Sci. 2009 May-Jun;17(3):179-83.
16. Moradi S, Ghoddusi J, Forghani M. Evaluation of dentinal tubule penetration after the use of dentin bonding agent as a root canal sealer. J Endod. 2009 Nov;35(11):1563-6.
17. Silva EJ, Perez R, Valentim RM, Belladonna FG, De-Deus GA, Lima IC, et al. Dissolution, dislocation and dimensional changes of endodontic sealers after a solubility challenge: a micro-CT approach. Int Endod J. 2017 Apr;50(4):407-14.
18. Mohammadian F, Farahanimastary F, Dibaji F, Kharazifard MJ. Scanning Electron Microscopic Evaluation of the Sealer-Dentine Interface of Three Sealers. Iran Endod J. 2017 Winter;12(1):38-42.
19. Forough Reyhani M, Ghasemi N, Rahimi S, Salem Milani A, Mokhtari H, Shakouie S, et al. Push-Out Bond Strength of Dorifill, Epiphany and MTA-Fillapex Sealers to Root Canal Dentin with and without Smear Layer. Iran Endod J. 2014 Fall;9(4):246-50.
20. Carvalho CN, Martinelli JR, Bauer J, Haapasalo M, Shen Y, Bradaschia-Correa V, et al. Micropush-out dentine bond strength of a new gutta-percha and niobium phosphate glass composite. Int Endod J. 2015 May;48(5):451-9.
21. Balguerie E, van der Sluis L, Vallaeys K, Gurgel-Georgelin M, Diemer F. Sealer penetration and adaptation in the dentinal tubules: a scanning electron microscopic study. J Endod. 2011 Nov;37(11):1576-9.
22. Shokouhinejad N, Sabeti M, Gorjestani H, Saghiri MA, Lotfi M, Hoseini A. Penetration of Epiphany, Epiphany self-etch, and AH Plus into dentinal tubules: a scanning electron microscopy study. J Endod. 2011 Sep;37(9):1316-9.
23. Vassiliadis LP, Sklavounos SA, Stavrianos CK. Depth of penetration and appearance of Grossman sealer in the dentinal tubules: an in vivo study. J Endod. 1994
Aug;20(8):373-6.
24. Mamootil K, Messer HH. Penetration of dentinal tubules by endodontic sealer cements in extracted teeth and in vivo. Int Endod J. 2007 Nov;40(11):873-81.
25. Steier L, de Figueiredo JAP, Belli S. Comparison of the interface dentin-endodontic sealer using two SEM magnifications. Rev Odonto Ciênc. 2010 Dec;25(3):296-9.
26. Grossman LI, Shepard LI, Pearson LA. Roentgenologic and clinical evaluation of endodontically treated teeth. Oral Surg Oral Med Oral Pathol. 1964 Mar;17:368-74.
27. Barbizam JV, Trope M, Tanomaru-Filho M, Teixeira EC, Teixeira FB. Bond strength of different endodontic sealers to dentin: push-out test. J Appl Oral Sci. 2011 Nov-Dec;19(6):644-7.
28. Sagsen B, Ustun Y, Demirbuga S, Pala K. Push-out bond strength of two new calcium silicate-based endodontic sealers to root canal dentine. Int Endod J. 2011 Dec;44(12):1088-91.
29. Marciano MA, Guimaraes BM, Ordinola-Zapata R, Bramante CM, Cavenago BC, Garcia RB, et al. Physical properties and interfacial adaptation of three epoxy resin-based sealers. J Endod. 2011 Oct;37(10):1417-21.
30. Wu MK, de Gee AJ, Wesselink PR. Effect of tubule orientation in the cavity wall on the seal of dental filling materials: an in vitro study. Int Endod J. 1998 Sep;31(5):326-32.
31. Sen BH, Büyükyilmaz T. The effect of 4% titanium tetrafluoride solution on root canal walls--a preliminary investigation. J Endod. 1998 Apr;24(4):239-43.
| Files | ||
| Issue | Vol 16, No 5 (2019) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/fid.v16i5.2278 | |
| Keywords | ||
| AH Plus Root Canal Filling Materials Root Canal Sealants Fluoride Varnish Scanning Electron Microscopy | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Omidi S, Ahadian A, Hadidi G, Mousavi SJ, Forghani M. Evaluation of Dentin Adaptability of Fluoride Varnish as a Root Canal Sealer Using Scanning Electron Microscopy. Front Dent. 2020;16(5):335-341.
