Root canal filling materials in primary teeth - review

Inadequate treatment of endodontic infections in primary teeth results in a loss of а deciduous tooth or abnormality in the development of hard dental tissues of the permanent successor. The main goal is to maintain the integrity and health of the primary tooth until their physiological exfoliation. The success of the endodontic treatment depends on the antimicrobial activity of the root canal filling material that contributes to the elimination or reduction of the microbial infection of the root canal system. The aim of this article is to systematically review the contemporary scientific literature concerning the root canal filling materials used in primary teeth. A critical evaluation of the antimicrobial activity, as well as the advantages and disadvantages of the investigated materials, has been made. Knowledge of the composition and characteristics of the available obturating materials is a useful advantage to dentists to address the functional problems associated with endodontic infections in very young patients. Future studies should also seek and compare the long-term effects of the use of traditional and alternative intracanal materials.

Comparação clínica e radiológica de pulpotomia em dentes decíduos com formocresol, MTA e biodentine

Introdução: O processo de pulpotomia convencionalmente é feito com formocresol, porém, devido as suas características mutagênicas, novos materiais obturadores foram desenvolvidos como alternativa. Objetivo: Revisar a literatura de forma integrativa a respeito do material obturador mais adequado para pulpotomia de dentes decíduos. Metodologia: A busca ocorreu nas bases de dados Pubmed e Medline, por meio dos descritores: “child”, “children”, “primary teeth”, “tooth, deciduous”, “primary tooth”, "pulpotomy", "pediatric dentistry", "endodontics", "root canal filling materials", "materials", "material", "biodentine", "mineral trioxide aggregate", "formocresol", "formocresols", "cytotoxicity", "biocompatible materials", "biocompatibility", "radiopacity", "radiographic" e "radiography, dental". Foram incluídos ensaios clínicos, estudos retrospectivos e estudos prospectivos, publicados entre 2016 e 2021, em inglês ou português. Os critérios de exclusão foram teses, dissertações, monografias, cartas ao editor, livros e revisões de literatura. Resultados: A pesquisa resultou em 9 estudos de ambas as bases de dados, com maior prevalência de ensaios clínicos. Conclusão: O material mais recomendado para realização de pulpotomias em dentes decíduos é o Biodentine e Mineral Trioxide Aggregate, devendo a escolha ser feita de acordo com o critério do profissional e caso do paciente. É preciso que seja considerado os custos e colaboração do paciente durante o tratamento.

Spectrophotometric evaluation of coronal discoloration induced by bioceramic root canal filling materials.

The aim of this study is to evaluate the crown discoloration induced by bioceramic root canal filling materials (OrthoMTA and iRoot SP) compared to AH Plus. Material and Methods: Sixty intact mandibular single rooted premolars were sectioned 2 mm below the cemento-enamel junction, prepared, and randomly assigned into four groups according to the root filling materials: OrthoMTA, iRoot SP, AH Plus and unfilled.Results: Before placement of the materials in the pulp chamber and the coronal third of the root, the spectral reflectance lines of the crowns were recorded by a digital spectrophotometer at baseline, and after filling at 1 week and 1, 3 and 6 months and ∆Ε values were calculated. All materials used induced clinically perceptible crown discoloration (ΔΕ>3.7) and no significant difference was detected between these materials (p>0.05). Regardless of the material, discoloration progressed significantly within the three months (p<0.05) however, at 6months, the discoloration reduced for AH Plus and no further increase for bioceramic materials was detected. Conclusion: Bioceramic root filling materials tested induced clinically perceptible crown discoloration and their application in the esthetic zone should be performed with caution.

Effect of Root Canal Filling Materials and Pretreatment with Solvents on the Shear Bond Strength of Composite Resin with Primary Tooth Dentin

Aim. Root canal filling materials have the tendency to inhibit adhesion of resin-based composites. This study was aimed at evaluating the effect of root canal filling materials and their solvents on the shear bond strength (SBS) of resin composite with the primary tooth dentin. Methods and Materials. Seventy-two intact anterior primary teeth were selected. Smooth dentinal surfaces were prepared to a minimum diameter of 3 mm and thickness of 1.5–2.0 mm. The samples were equally divided into six groups ( n = 12 ). In group 1: control group, no root filling material; in group 2: Metapex, no solvent; in group 3: Metapex+ethanol solvent; in group 4: ZOE, no solvent; in group 5: ZOE+ethanol solvent; and in group 6: ZOE+orange oil solvent were applied. Then, dentin surfaces were etched, and composite restorations were placed and cured. The specimens were stored in distilled water at 37°C for 24 hours. SBS values were determined using a universal testing machine. Results. The SBS values of composite to dentin in groups 2 and 4 were significantly lower than those in the control group ( P < 0.001 ). Cleansing of the specimens with 96% ethanol after removal of Metapex significantly increased the composite-dentin bond ( P < 0.001 ). Applying ZOE, only orange oil solvent significantly increased the SBS of the composite to the primary tooth dentin ( P = 0.01 ). Conclusion. To reduce the negative effects of endodontic root filling materials on the SBS of composite and primary tooth dentin, ethanol is a suitable solvent when Metapex is used, while orange oil might be a better choice than ethanol when applying ZOE.

Citric Acid: An Alternative for the Removal of Root Canal Filling Materials

Objectives: The aim of this study was to assess the potential of a smear-layer removing agent (citric acid) vs. an accepted gutta-percha-softening agent (Xylol) as an alternative substance for removing the root canal filling materials, while investigating the potential for associated demineralization effects. Materials and Methods: Seventy healthy, recently extracted premolars were used, ten as control, with sixty with their canals enlarged, shaped and cleaned and obturated using lateral compaction. Teeth were distributed into 3 groups as follows: 1) no solvent and mechanical removal of the filling materials; 2) 1ml of Xylol for 1 minute followed by mechanical removal; and 3) 10% citric acid for 1 minute followed by mechanical removal. Two sections of the root were used, one for Raman spectroscopy analysis to evaluate morphological changes in dentine surface and the other for micro-hardness testing (Vickers). Results: The use of 10% citric acid in in the removal of gutta-percha and sealer was more effective than the Xylol and mechanical group (p<0.05), presented less remnants of filling material debris and with non-observable demineralizing effects. Conclusion: Citric acid might be considered as a viable alternative in the removal of gutta-percha and sealer during root canal retreatment.Clinical Relevance: This research showed how citric acid can be used as an alternative in endodontic retreatment; how efficiently removed the filling material without damaging the dental tissue.