Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Advanced and Digital Endodontic, Restorative and Prosthodontic Treatment (TADERP) Research Center, Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Medicina (Kaunas). 2023 Jun 13;59(6):1137. doi: 10.3390/medicina59061137.
Recognizing the significance of a hermetic apical seal for successful root canal treatment, the present investigation aimed to evaluate two sealing materials through an in vitro analysis, as well as to ascertain the clinical outcomes of patients treated with these two sealers in an in vivo setting. For the in vitro part of the study, two control groups of thirty monoradicular teeth were obturated with two sealers. Then, the sealers' performance was tested based on a predefined protocol. Group A included 30 patients treated with an epoxy oligomer resin-based sealer (Adseal, MetaBiomed), while Group S comprised 30 patients treated with a polymeric calcium salicylate-based sealer (Sealapex, Kerr). Samples were sectioned and evaluated under the microscope to determine the sealer's tightness by measuring the dye penetration into the root canal filling. For the in vivo part, a prospective study was designed to include 60 patients with chronic apical periodontitis in two endodontic treatment groups, using the same two sealers. The in vitro analysis found that dye penetration in Group A was 0.82 mm (±0.428), while in Group S, the dye penetration was statistically significantly deeper, being 1.23 mm (±0.353). In the in vivo part of the study, the periapical index (PAI) significantly decreased 6 months after endodontic treatment, with 80.0% of patients in Group A having a PAI score of 2 compared to only 56.7% in Group S (-value = 0.018). Similarly, tooth mobility scores significantly decreased after treatment, but with no difference between groups. The marginal bone loss decreased significantly more in the Adseal group compared to the Sealapex group (23.3% vs. 50.0%, -value = 0.032). At the same time, 40.0% of patients in Group S had failed tooth healing compared to only 13.3% in Group A (-value = 0.048). The in vitro study showed that Adseal had a better sealing capacity and a lower degree of dye penetration compared to Sealapex. However, on clinical evaluation in the in vivo study, both patient groups exhibited significant improvements in periapical index, tooth mobility scores, and pain reduction following endodontic treatment. Nevertheless, patients treated with Adseal showed a significantly greater improvement in PAI values, tooth mobility, and teeth healing after treatment. Overall, Adseal, as an endodontic sealer, may provide better sealing capabilities and enhanced clinical outcomes in the treatment of chronic apical periodontitis.
认识到根管治疗成功的一个重要因素是密封的根尖封闭，本研究旨在通过体外分析评估两种密封材料，并确定在体内环境中使用这两种密封剂治疗的患者的临床结果。
在研究的体外部分，两组 30 颗单根管牙用两种密封剂进行了填充。然后，根据预定义的方案测试密封剂的性能。A 组包括 30 名用环氧树脂基聚合体密封剂（Adseal，Meta Biomed）治疗的患者，而 S 组包括 30 名用聚合体水杨酸钙基密封剂（Sealapex， Kerr）治疗的患者。对样本进行切片，并在显微镜下进行评估，通过测量染料渗透到根管填充中来确定密封剂的密封性。
在体内部分，设计了一项前瞻性研究，将 60 名患有慢性根尖周炎的患者分为两组，分别使用这两种密封剂进行根管治疗。体外分析发现，A 组的染料渗透为 0.82 毫米（±0.428），而 S 组的染料渗透深度统计学上显著更深，为 1.23 毫米（±0.353）。
在体内部分的研究中，根管治疗后 6 个月时，根尖指数（PAI）显著降低，A 组有 80.0%的患者的 PAI 评分为 2，而 S 组只有 56.7%（-值=0.018）。同样，治疗后牙齿活动评分也显著降低，但两组之间没有差异。与 Sealapex 组相比，Adseal 组的边缘骨损失显著减少（23.3%对 50.0%，-值=0.032）。同时，S 组有 40.0%的患者出现牙齿愈合失败，而 A 组只有 13.3%（-值=0.048）。
体外研究表明，与 Sealapex 相比，Adseal 具有更好的密封能力和较低的染料渗透程度。然而，在体内研究的临床评估中，两组患者在根管治疗后，根尖指数、牙齿活动评分和疼痛减轻方面均有显著改善。然而，用 Adseal 治疗的患者在 PAI 值、牙齿活动和牙齿愈合方面的改善更为显著。
总的来说，作为一种根管密封剂，Adseal 可能在治疗慢性根尖周炎时提供更好的密封性能和更理想的临床效果。
