Comparative Evaluation of Periapical Healing in response to Calcium hydroxide, Polydimethyl siloxane and Calcium Silicate based endodontic sealers using radiograph.

Abstract

Background: Success of root canal treatment depends upon 3-D seal obtained after obturation without any presence of post-operative symptoms. The focus of this investigation is on ability of a sealer to form 3D seal and to reduce periapical lesion. The study aims to evaluate periapical healing of teeth treated with calcium hydroxide, polydimethyl siloxane and calcium silicate based endodontic sealers using radiograph. The objectives of this study will be to evaluate periapical healing ability of root canal treated teeth with Diaproseal, Nanoseal-S and Bio-ceramic sealers over the time period of 3, 6 and 9 months; and to compare the periapical healing ability of a root canal treated tooth.

Methods:  A total of 60 subjects having periapical radiolucencies will be divided into 3 groups of 20 subjects each; Group I- Calcium hydroxide based, Group II- Polydimethyl siloxane based and Group III- Calcium Silicate based sealers. Root canal procedure will be done. Patients will be recalled after 3, 6, 9 months for the evaluation of periapical healing and PAI score check-up using intraoral periapical radiograph.

Expected results: It is expected that among the material used in the study Bio-Ceramic and Nanoseal-S sealer may give better results as compared to  used in routine practice due to its ability of anti-microbial properties, optimal biocompatibility and excellent sealing ability.

AIM: To evaluate periapical healing of teeth treated with Calcium hydroxide, Polydimethyl siloxane and Calcium Silicate based endodontic sealers using radiograph.

METHOD AND MATERIALS:Materials required: -

Dia-proseal, Calcium hydroxide based Root Canal Sealer

Compositions: Paste A Epoxy resin, zirconium oxide, calcium hydroxide

Paste B Calcium tungstate, zirconium oxide, calcium hydroxide

Manufacturer: Diadent, Cheongju, Korea

  Nanoseal-S

Composition: Polydimethyl siloxane, Nano Silver powder, Silicone Oil, Platinum Catalyst, Zirconium Dioxide, Paraffin Liquid.

Manufacturer: PrevestDenpro, USA

 Meta CeraSeal Calcium Silicate-based Bio-ceramic Root Canal Sealer Composition: Zirconium oxide, calcium silicates, calcium phosphate, calcium hydroxide, filler, and thickening agents.

Manufacturer: Meta Biomed, Korea

 Criteria used for evaluation: - Radiograph

 Periapical index (PAI)

   

Score

Quantitative bone alterations in mineral structures

|0

Intact periapical bone structures

|1

Diameter of periapical radiolucency 0.5–1 mm

|2

Diameter of periapical radiolucency 1–2 mm

|3

Diameter of periapical radiolucency 2–4 mm

|4

Diameter of periapical radiolucency 4–8 mm

|5

Diameter of periapical radiolucency >8 mm

|E

Expansion of periapical cortical bone

|D

Destruction of periapical cortical bone

  SELECTION CRITERIA🞂          Inclusion criteria

·       Patients requiring endodontic treatment

 Â·       Periapical radiolucency of teeth ranging from (0.5mm – 8 mm)

 ðŸž‚          Exclusion criteria·        Medically / systemically compromised patients (with immunosuppressive/systemic diseases, patients on medications)

·        Teeth with Inability to reach the full working length

EXPECTED RESULT: - It is expected that among the material used in the study Bio-Ceramic and Nanoseal-S sealer may give better results as compared to Sealapex used in routine practice due to its ability of anti-microbial properties, optimal biocompatibility and excellent sealing ability.

Conclusion Comparison amongst the three sealers would provide us with the information about the best material which offers better periapical healing to get the best outcome of the root canal treatment by clinician.