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Browsing by Author "Vail, Mychel Macapagal, 1969-"

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    Antibacterial efficacy of 0.12-percent and 2.0-percent chlorhexidine gluconate at 37˚C and 46˚C against enterococcus faecalis
    (2010) Thiessen, Craig B.D., 1978-; Vail, Mychel Macapagal, 1969-; Spolnik, Kenneth Jacob, 1950-; Zunt, Susan L., 1951-; Gregory, Richard L.; Legan, Joseph J.
    The purpose of this study was to investigate the antibacterial efficacy of 0.12-percent and 2.0-percent chlorhexidine gluconate (CHX) on eliminating Enterococcus faecalis from dentinal tubules, and whether this antibacterial effect was enhanced by heat. To date there have been no published articles that describe the heating of 2.0-percent CHX and its antimicrobial efficacy and clinical relevance towards E. faecalis within dentinal tubules in root canal systems. Ninety-five human extracted, single rooted, maxillary, anterior teeth were used to prepare dentin disk specimens. After proper sterilization, a 2.5-mm ISO-sized diameter lumen was prepared, and then the canals were filled with brain-heart infusion (BHI) broth infected with E. faecalis. The BHI was removed and the specimens in equally divided groups were rinsed with sterile saline and filled with saline, or 0.12 percent CHX or 2.0 percent CHX at ambient temperature (24°C) or experimental temperature (46°C) and incubated at oral temperature (37°C) or the experimental temperature (46°C), respectively. The specimens were frozen to -70˚C and pulverized in liquid nitrogen. Serial dilutions were prepared of 1:100 and 1:1000 and spiral plated on BHI agar plates in duplicate. They were incubated, and the number of bacterial colonies was recorded 24 hours later for data analysis. A two-way analysis of variance (ANOVA), with factors for solution, solution temperature, and the solution-by-temperature interaction was used to determine antibacterial efficacy. Pair-wise comparisons between groups were examined for significance using the Fisher’s Protected Least Significant Differences Method. The E. faecalis CFU were log-transformed to satisfy the assumptions required for the ANOVA. The results of this investigation demonstrated no statistically significant difference with the addition of heat to either test irrigation solution regarding the elimination of E. faecalis from dentinal tubules within the root canal system. There was a statistically significant difference in the antibacterial efficacy of CHX against E. faecalis in comparison with the concentration tested. A higher concentration of 2.0-percent CHX demonstrated a significantly higher antibacterial efficacy against E. faecalis compared with 0.12-percent CHX, and likewise with the saline control. It can be concluded that the use of a higher concentration of 2.0-percent CHX is advantageous as a final irrigation solution after copious amounts of NaOCl and EDTA have been utilized for effective antimicrobial efficacy and substantivity.
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    Antimicrobial properties of drug-containing electrospun scaffolds
    (2012) Jeppson, John; Spolnik, Kenneth Jacob, 1950-; Vail, Mychel Macapagal, 1969-; Erhlich, Ygal; Bottino, Marco C.; Gregory, Richard L.; Legan, Joseph J.; Zunt, Susan L., 1950-
    Endodontic treatment of the infected immature tooth has undergone a dramatic change. Conventional endodontic treatment can control infection, but root development usually remains impaired. A novel regenerative endodontic procedure, the revascularization method, can now control the infection and enable such teeth to continue root development. This is done by creating a fibrin-matrix scaffold in the antibiotic treated root canal space (RCS). Dental stem cells and growth factors have been able to continue root development in such an environment. The fibrin-matrix scaffold is dependent on the induction of a blood clot into the RCS, and this cannot always be predictably induced. PDS is a biocompatible material that can be electrospun to provide a matrix for cells and growth factors and perhaps improve on the blood clot induced fibrin scaffold by incorporating metronidazole as an adjuvant antimicrobial. A metronidazole containing electrospun PDS scaffold was examined in vitro using a turbidimetric test, the modified direct contact test. This scaffold significantly inhibited growth of an anaerobic primary endodontic pathogen Porphyromonas gingivalis. This scaffold may improve the treatment of the infected immature tooth by providing a designed matrix for root regeneration while serving simultaneously as an antibiotic drug delivery device to disinfect the RCS. The aim of this study is to evaluate in vitro the property of a synthetic scaffold to function as an antibacterial drug delivery device. PDS*II (polydioxanone) suture was obtained from Ethicon, INC. (Somerville, NJ) and was dissolved in 1,1,1,3,3,3-hexafluoro-2-propanol, HFIP (Sigma Aldrich). Three different scaffolds were electrospun onto an aluminum foil background; (1) control scaffold with no antibiotic incorporated, (2) scaffold with 5.0-wt % metronidazole incorporated, and (3) 25-wt % metronidazole incorporated. All scaffolds were cut using a 4-mm diameter biopsy punch under aseptic conditions and removed from foil, control scaffold (n = 64), scaffold containing 5.0-wt % metronidazole (n = 32), and scaffold containing 25-wt % metronidazole (n=32). Experimental scaffolds were placed in a 96- well sterile flat bottom microtiter plate. Porphyromonas gingivalis a known primary endodontic pathogen was grown in 5 ml of BHI + YE with 0.25 μl of vitamin K with incubation at 37°C under anaerobic conditions for 48 hours. Microplates were sterilized before inoculation with Pg with 400 μl of 70-percent EtOH for a minimum of 30 minutes then pipetted out. After sterilization the microwells were washed with 400 μl of sterile water and pipetted out. Group 1 (negative control) microwells (n = 8) contained control scaffold and 190 μl of broth only. Group 2 (positive control) microwells (n = 8) contained 190 μl of broth and Pg only. Group 3 microwells (n = 8) contained control scaffold, 190 μl of broth, and 10 μl of Pg inoculum. Group 4 microwells (n = 8) contained scaffold with 5 wt % metronidazole, 190 μl of broth, and 10 μl of Pg inoculum. Group 5 microwells (n = 8) contained scaffold with 25 wt % metronidazole, 190 μl of broth, and 10 μl of Pg inoculum. Group 6 contained 190 μl of uninoculated broth for spectrophotometer calibration. Sterile microplate lids were used to isolate microwells from the surrounding environment. Microplates were incubated at 37°C under anaerobic conditions for 48 hours. After 48 hours the microplates were read by using an endpoint reading in the spectrophotometer. This was repeated four times. Comparisons among the groups for differences in optical density as a measure of bacterial growth were made using mixed-model ANOVA, with a fixed effect for group and a random effect for experimental run. Pair-wise group comparisons were performed using Tukey's multiple comparisons procedure to control the overall significance level at 5 percent. The analyses were performed using the ranks of the data. Broth had significantly lower OD than all other groups (p < 0.0001). Broth+Pg and Broth+Pg+Scaffold had significantly higher OD than 5-wt % Metro (p < 0.0001) and 25-wt % Metro (p < 0.0001), but Broth+Pg and Broth+Pg+Scaffold were not significantly different from each other (p = 0.97). 5-wt % Metro and 25-wt % Metro were not significantly different from each other (p = 0.24). From the results of our study, we concluded that the 5.0-wt % and 25-wt % metronidazole containing scaffolds significantly inhibited bacterial growth and could be effectively utilized for the endodontic regeneration procedure.
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    Biodegradability of resilon, a resin based root canal obturating material, by typical endodontic pathogens
    (2012) Rexford, Ashleigh M.; Spolnik, Kenneth Jacob, 1950-; Vail, Mychel Macapagal, 1969-; Hara, Anderson T.; Ehrlich, Ygal; Zunt, Susan L., 1951-; Gregory, Richard L.; Legan, Joseph J.
    Root canal therapy is a recommended treatment for apical periodontitis. Root canal failure can occur as a result of microbial leakage. Resilon, a resin based root canal obturating cone material introduced in 2004 attempts to minimize leakage by a unique bonding method of the resin sealer to both the core material and to the dentin of the canal walls. Resilon has no bactericidal or antimicrobial effect15. Furthermore, it has been shown that Resilon is susceptible to alkaline and enzymatic hydrolysis as well as bacterial degradation.73, 184-186 It has been suggested that Resilon may be susceptible to degradation by microorganisms found in the infected root canal space. This work focuses on the susceptibility of root canal obturating materials to be degraded by endodontic pathogens seen in root canal treated teeth with apical periodontitis. The aim of this study was to determine if Resilon could be degraded by selected pathogenic bacteria found in the infected root canal system, and if this degradation is more severe than with gutta-percha, a conventional obturating material. P. intermedia, E. faecalis and P. aeruginosa, known endodontic pathogens were inoculated on discs of obturating material (Resilon or gutta-percha) mounted on a platform and placed in wells containing TSB incubated at 37°C under aerobic conditions. The discs were polished, examined by SEM, profilometry, and elemental analysis prior to inoculation to establish a baseline, and were then re-examined by these methods one month after inoculation. The overall results were inconclusive; and using these methods it cannot be determined that the selected bacteria can degrade Resilon. An ideal future study would utilize SEM with gold coated samples as well as atomic force microscopy to evaluate for changes in topographical features of these obturating materials. A notable finding was that Resilon turns black when exposed to bacteria, and the significance of this finding should be addressed in future studies.
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    The effect of endodontic regeneration medicaments on mechanical properties of radicular dentin
    (2013) Yassen, Ghaeth H.; Platt, Jeffrey A., 1958-; Chu, Tien-Min Gabriel; Murray, Peter E.; Allen, Matthew R.; Vail, Mychel Macapagal, 1969-
    Endodontic regeneration treatment of necrotic immature teeth has gained popularity in recent years. The approach suggests a biological alternative to induce a continuous root development. In this project, three in vitro experiments were conducted to investigate the effect of three medicaments used in endodontic regeneration on mechanical properties and chemical structure of radicular dentin. In the first experiment, we investigated longitudinally the effect of medicaments on the indentation properties of the root canal surface of immature teeth using a novel BioDent reference point indenter. A significant difference in the majority of indentation parameters between all groups was found after one-week and one-month application of medicaments (p<0.0001): triple antibiotic paste (TAP) > double antibiotic paste (DAP) > control > calcium hydroxide [Ca(OH)2]. The four-week exposure of dentin to TAP and DAP caused 43% and 31% increase in total indentation distance outcome, respectively. In the second experiment, we investigated longitudinally the effect of medicaments on the chemical structure of immature radicular dentin by measuring the phosphate/amide I ratios of dentin using Attenuated Total Reflection Fourier Transform Infrared Spectroscopy. Phosphate/amide I ratios were significantly different between the four groups after one week, two weeks and four week application of medicaments (p<0.0001): Ca(OH)2-treated dentin > untreated dentin > DAP-treated dentin > TAP-treated dentin. In the third experiment, we investigated longitudinally the effect of medicaments on root fracture resistance and microhardness of radicular dentin. For the microhardness, the two-way interaction between group and time was significant (p<0.001). TAP and DAP caused a significant and continuous decrease in dentin microhardness after one and three month application, respectively. The three-month intracanal application of Ca(OH)2 significantly increased the microhardness of root dentin. The time factor had a significant effect on fracture resistance (p<0.001). All medicaments caused significant decrease in fracture resistance ranging between 19%-30% after three month application compared to one week application. The three medicaments used in endodontic regeneration caused significant change in the chemical integrity of the superficial radicular dentin and significantly affected the indentation properties of the root canal surface. Furthermore, the three month intracanal application of medicaments significantly reduced the fracture resistance of roots.
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    Effects of DynaMatrix® Membrane on Angiogenic Cytokine Expression From Human Dental Pulp Stem Cells
    (2013) Baker, Ryan William; Spolnik, Kenneth Jacob, 1950-; Ehrlich, Ygal; Vail, Mychel Macapagal, 1969-; Song, Fengyu; Legan, Joseph J.; Zunt, Susan L., 1951-; Windsor, L. Jack
    The aim of this current study was to determine if the exposure of human dental pulp stem cells (HDPSC) to the DynaMatrix membrane will result in an increased production of angiogenic cytokines that are critical for pulp/root regeneration. Angiogenesis cytokine arrays have been established as a viable method for assessing expression of cytokines.20 HDPSC were chosen as they are expected to be found in the apical papilla and the infected immature root canal system of teeth that current regenerative endodontic techniques are designed to treat.
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    Efficacy of propolis against fusobacterium nucleatum biofilm
    (2013) Griglione, Anthony Leonard; Spolnik, Kenneth Jacob, 1950-; Gregory, Richard L.; Vail, Mychel Macapagal, 1969-; Legan, Joseph J.; Zunt, Susan L., 1951-; Eckert, George J.; Ehlich, Ygar
    The primary goal of root canal treatment is to eliminate microbes from the root canal system, which is the cause of pulpal and periapical infections. Research shows that after a single visit of chemomechanical debridement microbes continue to remain within the canal system. An interappointment medication step has been advocated to maximize potential elimination of microbes within the root canal system. Previous studies have shown propolis to be antibacterial against common endodontic microbes. Studies have shown trends in different microbes being present in primary verus secondary endodontic infections. The majority of literature has focused on the efficacy of propolis against Enterococcus faecalis, a microbe commonly implicated in secondary endodontic 95 infections. The aim of this study was to demonstrate the efficacy of propolis against Fusobacterium nucleatum, a microbe commonly found in primary endodontic infections. This study aims to demonstrate the efficacy of propolis against a bacterium of primary endodontic infections (F. nucleatum) as well as against microbial biofilm to further support its potential use as a novel intracanal medicament. Dilutions of propolis were added to cultures of F. nucleatum in microtiter plates in a range from 390 μg/ml to 50,000 μg/ml. The minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and the minimum biofilm inhibitory concentration (MBIC) were determined. The MIC was determined of the total solution (biofilm+planktonic), planktonic, and biofilm (MBIC) after a 48-hour incubation period. The MBIC was determined by fixing biofilm to the wells and using crystal violet staining with spectrophotometry. The MBC was examined by plating solution from each concentration test well and reading the plates after 48 hours of incubation. The results show that the MIC of the total (biofilm+planktonic) appears to occur at a concentration of 6250 μg/ml. The MBIC appears to occur at the concentration of 1562.5 μg/ml. The planktonic results exhibit no significant difference in test and control wells. There was no MBC at any of the test concentrations. The propolis appears to inhibit bacterial growth and biofilm formation but does not appear to be bactericidal at any of the tested concentrations. The results of this study indicate that propolis has an MIC and MBIC when tested in vitro against F. nucleatum, although it does not show an MBC. There appears to be potentially significant interaction of propolis with biofilm as displayed by the lower concentration needed to exibit inhibitory effects on biofilm formation. This information 96 may contribute to the ability to develop a proper concentration of propolis to use in vivo when treating endodontic infections.
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    An in vitro comparison of working length accuracy between a digital system and conventional film when vertical angulation of the object is variable
    (2009) Christensen, Shane R. (Robert), 1977-; Vail, Mychel Macapagal, 1969-; Legan, Joseph J.; Parks, Edwin T. (Edwin Thomas), 1955-; Zunt, Susan L., 1951-; Spolnik, Kenneth Jacob, 1950-
    Accurate determination of working length during endodontic therapy is critical in achieving a predictable and successful outcome. Working length is determined by the use of electronic apex locators, tactile perception, knowledge of average tooth lengths and dental radiography. Due to the increasing use of digital radiography in clinical practice, a comparison with conventional film in working length determination is justified. The purpose of this study is to determine if there is a difference between Schick digital radiography and Kodak Ultra-speed film in the accurate determination of working lengths when vertical angulation of the object is variable. Twelve teeth with #15 K-flex files at varying known lengths from the anatomical apex were mounted in a resin-plaster mix to simulate bone density. A mounting jig for the standardization of projection geometries allowed for exact changes in vertical angulation as it related to the object (tooth) and the film/sensor. Each tooth was imaged using Schick CDR and Kodak Ultra-speed film at varying angles with a consistent source-film distance and exposure time. Four dental professionals examined the images and films independently and measured the distance from the tip of the file to radiographic apex and recorded their results. The error in working length was calculated as the observed value minus the known working length for each tooth type. A mixed-effects, full-factorial analysis of variance (ANOVA) model was used to model the error in working length. Included in the ANOVA model were fixed effects for type of image, vertical angulation, and the interaction of angle and film type. Tooth type and examiner were included in the model as random effects assuming a compound symmetry covariance structure. The repeatability of each examiner, for each film type, was assessed by estimating the intra-class correlation coefficient (ICC). The ICC was determined when 12 randomly selected images and radiographs were reevaluated 10 days after initial measurements. The repeatability of each examiner for Schick CDR was good with ICCs ranging from 0.67 to 1.0. Repeatability for the conventional film was poor with ICCs varying from -0.29 to 0.55. We found the error in the working length was not significantly different between film types (p = 0.402). After adjusting for angle, we found that error in the working length from the digital image was only 0.02 mm greater (95-percent CI: -0.03, 0.06) than the conventional film. Furthermore, there was not a significant difference among the angles (p = 0.246) nor in the interaction of image type with angle (p = 0.149). Based on the results of our study, we conclude that there is not a statistically significant difference in determining working length between Schick CDR and Kodak Ektaspeed film when vertical angulation is modified.
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    An in-vitro comparison of bacterial microleakage of gutta-percha and the Guttacore cross-linked gutta-percha core obturator
    (2013) Edds, Abigail C.; Spolnik, Kenneth Jacob, 1950-; Gregory, Richard L.; Vail, Mychel Macapagal, 1969-; Legan, Joseph J.; Zunt, Susan L., 1951-; Ehrlich, Ygal
    Root canal therapy requires three important steps accomplished in concert to achieve long-term success: canal shaping, disinfection, and obturation. Traditionally gutta-percha has been used with sealer in a cold lateral condensation technique. Schilder introduced the concept of warm vertical compaction of gutta-percha in 1967 to attempt to obturate more canal irregularities. Johnson presented the use of stainless steel files with thermally plasticized gutta-percha in 1978, and later the metal carrier was changed to plastic and named Thermafil. Thermafil has shortcomings in that it does not always fulfill Grossman’s obturation material properties, such as apical extent of the material (extrusion) and ease of retreatment. A new obturation material by Dentsply Tulsa, the GuttaCore cross-linked gutta-percha core obturator, has been introduced that replaces the plastic core with a cross-linked gutta-percha core. The manufacturer states removal of the obturation material and 89 core is fast and easy. To date, no microleakage studies have been done to test this newer obturation material. Methods used to study microleakage have included the use of dyes, radioisotopes, electrochemicals, fluid filtration, and microorganisms. A microbial leakage model has been constructed using a modified two-chamber apparatus as described by Torabinejad et al. and has been used successfully. Green fluorescent protein (GFP) from the jellyfish Aequorea victoria is useful as a bacterial label because the fluorescent marker can be exhibited in the bacterial host without having to use stains. A plasmid that encodes for a copy of the green fluorescent variant gene was transferred into the E. faecalis. The marker glows green under a standard fluorescence microscope and has been used successfully to evaluate microleakage. The purpose of this investigation was to evaluate the sealing ability of a new obturation material, GuttaCore, to determine if there will be a significant decrease in microleakage of AH Plus with GuttaCore obturator versus AH Plus with gutta-percha. Sixty-two human, single-rooted premolars extracted for periodontal considerations were accessed and instrumented for non-surgical root canal therapy. Hand and rotary instrumentation was accomplished to MAF size 40.04, and irrigation was accomplished with 6.0-percent NaOCl and 17-percent EDTA with use of EndoActivator. Teeth were randomly assigned to two experimental groups of 27 teeth each. Group I (conventional method) teeth were obturated with gutta-percha and AH Plus sealer using warm vertical condensation, and Group II (test method) teeth were obturated with GuttaCore and AH Plus sealer. Two control groups containing four teeth each 90 served as positive and negative controls. The positive and negative control groups ensured that the microleakage model was working correctly. The teeth were evaluated for microbial microleakage of E. faecalis green fluorescent protein (GFP) construct using a dual chamber leakage model. If turbidity is observed in the lower chamber, it will indicate microleakage and an inadequate seal of the obturation method. The teeth were sectioned and viewed with a standard fluorescence microscope to determine the depth of microleakage utilizing the inherent fluorescence of the E. faecalis GFP construct. No microleakage was observed in the negative control groups. Microleakage was observed in both gutta-percha positive control groups and in one of the two GuttaCore positive control groups. One of 27 GuttaCore samples displayed turbidity, which occurred at day 14. None of the 26 gutta-percha samples displayed turbidity at any point. The 95-percent confidence intervals (CI) for the percentage of samples with turbidity were 0.1 percent to 19 percent for GuttaCore and 0.0 percent to 13.2 percent for gutta-percha using a Fisher’s Exact Test. The two groups did not have a significantly different percentage of samples with turbidity (p =1.00). No E. faecalis GFP was visualized under fluorescent microscopy in either the turbid GuttaCore sample or the gutta-percha positive control in the apical, middle or coronal thirds. Both samples that demonstrated microleakage had confirmation that the lower chamber broth contained E. faecalis GFP when cultured on blood agar plates. Within the limitations of this study, there was no significant decrease in microleakage between the GuttaCore obturator and warm vertical condensation with gutta-percha. Turbidity of the broth in samples that leaked was not associated with 91 noticeable bacteria when using fluorescent microscopy, which indicated that leakage may be the result of very few bacteria.
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    An In-Vitro Comparison of Microleakage With E. faecalis In Teeth With Root-End Fillings of Proroot MTA and Brasseler's EndoSequence Root Repair Putty
    (2011) Brasseale, Beau J. (Beau John), 1980-; Spolnik, Kenneth Jacob, 1950-; Vail, Mychel Macapagal, 1969-; Legan, Joseph J.; Zunt, Susan L., 1951-; Moore, B. Keith; Gregory, Richard L.
    Brasseler USA (Savannah, GA) developed and introduced a bioceramic putty called EndoSequence Root Repair Material (ERRM) that can be used as a retrofilling material for surgical endodontics. The material is said to have many of the same chemical, physical, and biological properties as mineral trioxide aggregate (MTA), but with superior handling characteristics. The material is composed of calcium silicates, monobasic calcium phosphate, zirconium oxide, tantalum oxide, proprietary fillers, and thickening agents. ERRM is said by the manufacturer to bond to adjacent dentin, have no shrinkage, be highly biocompatible, hydrophilic, radiopaque, and antibacterial due to a high pH during setting. Investigations on the sealing properties of this material have not yet been conducted. The purpose of this study was to compare the microbial leakage of Enterococcus faecalis in teeth with root-end fillings using ProRoot MTA and Brasseler’s ERRM in a dual-chamber bacterial leakage model as described by Torabinejad and colleagues. The aim of this investigation was to compare the bacterial microleakage of these two root-end filling materials exists. Sixty-two human, single-rooted, mandibular premolars in which extraction was indicated were accessed and instrumented in an orthograde fashion with hand and rotary files. Root resection of the apical 3 mm was then completed and root-end retropreparations were created for placement of root-end filling material. Twenty-seven of these premolars had root-end fillings using ProRoot MTA and 27 had root-end fillings using ERRM. Two teeth were used as a positive control group with no root-end filling, and two other teeth were used as a negative control group and were sealed and coated with dentin bonding agent. The teeth were then evaluated for microleakage using a dual-chamber bacterial microleakage model for 40 days as described by Torabinejad and colleagues. Microleakage was determined by the presence of turbidity in the lower chamber of the apparatus and was assessed each day. Fresh samples of E. faecalis were used every three days to inoculate the apparatus and serve as a bacterial challenge for the materials. Results were recorded every day for 30 days. The outcome of interest (bacterial turbidity) and time-to-leakage (in days) were determined for each of the samples. Survival analysis was used to compare the two groups with a Kaplan-Meier plot to visualize the results and a nonparametric log-rank test for the group comparison. The microleakage of ERRM was not statistically different (p > 0.05) than leakage of ProRoot MTA when subjected to E. faecalis over the 40 day observation period. Both groups had a small number of early failures (within 4 days) and no leakage was observed for the remaining 40 days of the study. Therefore, the null hypothesis was rejected. The results of this research support the use of either of these two materials when compared with the controls. The microleakage of Brasseler’s EndoSequence Root Repair Material was at least as good as ProRoot Mineral Trioxide Aggregate when tested with E. faecalis.
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    An in-vitro comparison of the microleakage of RealSeal/Resilon and RealSeal Self-Etch/Resilon root canal obturation system
    (2011) Iqbal, Haris; Spolnik, Kenneth Jacob, 1950-; Vail, Mychel Macapagal, 1969-; Legan, Joseph L.; Gregory, Richard L.; Moore, B. Keith; Zunt, Susan L., 1951-
    The purpose of this investigation was to evaluate and compare microleakage of teeth obturated using either RealSeal/Resilon or RealSeal Self-Etch/Resilon systems. The goal was to determine whether a significant difference in microleakage exists between these two groups. To date, no study has been done comparing the microleakage of root canal systems obturated with using RealSeal/Resilon versus RealSeal SE/Resilon. Sixty-two human, single-rooted, anterior teeth were accessed and instrumented for non-surgical root canal therapy. Teeth were randomly assigned to two experimental groups of 27 teeth each. Group I consisted of teeth obturated with the RealSeal/Resilon system, whereas Group II consisted of teeth obturated with the RealSeal SE/Resilon system. In addition, two control groups containing four teeth each served as positive and negative controls, Group (+) and Group (-), respectively. The teeth were then evaluated for microleakage using a dual-chamber microleakage model. Visual turbidity in the lower chamber denoted microleakage within the experimental groups observed for 33 days. RealSeal SE Group II had a significantly higher proportion of samples than Real Seal Group I. Time to microleakage was also significantly lower in RealSeal SE Group II than in Real Seal Group I. No microleakage was observed in the negative control and microleakage was observed in all four samples in the positive control. To date, this is the first study comparing the microleakage of RealSeal/Resilon and RealSeal SE/Resilon systems. The higher microleakage associated with RealSeal SE is attributed to the higher pH of the self-etch (SE) sealer in comparison with the self-etch primer of RealSeal. The self-etching potential of the sealer system is particularly critical in areas inaccessible to calcium chelating agents such as EDTA in root canal systems. Further research needs to be done to corroborate the microleakage results from this study. The microbial leakage apparatus devised in this study, which used a selective growth medium with streptomycin, has also been validated by the results of the study. The bacterial leakage apparatus has been considered to be clinically relevant and acceptable by the Journal of Endodontics. Thus, the modified dual-chambered microleakage apparatus with a selective growth medium used in this research can be replicated easily in future microleakage studies.
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