Herbal remedies have demonstrated remarkable effects as anti-diabetic, anticancer, antimicrobials, immunological modulatory agent in liver problems, respiratory illnesses, and as beauty agents. The need for more affordable, readily accessible, and alternative medicines has led to a rise in the recognition of herbal drugs. Therefore, it is of interest to evaluate and compare the effectiveness of photosensitized curcumin fibers, Aloevera, Amla Juice and Pancha Tulsi in disinfecting guttapercha (GP) cones. It was observed that all experimental disinfectants were found to have greater antimicrobial action than the positive control in which no disinfectant was used. The order of antimicrobial action among different experimental disinfectants against Staphylococcus aureus and Enterococcus faecalis in disinfection of GP cones was in following order PanchaTulsi>Curcumin fibers >Amla juice > Aloe vera. It was concluded that all herbal disinfectants were found to have antimicrobial effectiveness in disinfection of GP cones with Panchtulsi having maximum disinfectant ability followed by photosensitized curcumin fibres.

OBJECTIVE: To investigate the effect of GuttaFlow Bioseal root canal sealer on the vertical root fracture resistance of oval-shaped root canals.
METHODS: Sixty orthodontically subtracted maxillary and mandibular single-rooted premolar teeth were scanned with CBCT. Oval canals were eligible when the buccolingual diameter of the canal was greater than or equal to two times the mesiodistal diameter at a distance of 5 mm from the root apex. Thirty single-rooted premolars with oval-shaped root canals were prepared to F2 using the Protaper system and then randomly divided into the GuttaFlow Bioseal filling group and iRoot SP filling group. Each group was further divided for root canal filling using warm vertical compression, cold lateral condensation and single cone techniques. Five single-rooted premolars was chosen as a negative control group. After 30 days of storage in a constant thermotank at 37 ℃ and 100% humidity, the filled roots were vertically placed into a cylindrical model of self-polymerizing acrylic resin. Subsequently, the samples were fixed on the lower plate of a universal testing machine, and a ball of 4 mm in diameter was applied vertically with a downward pressure at a speed of 1 mm/min until fracture occurred. The load values were recorded in Newtons. The data were analyzed using SPSS 29.0 software package. Fracture patterns were examined under microscope.
RESULTS: T test results showed no significant difference between the GuttaFlow Bioseal-filled and iRoot SP-filled groups (P=0.321). One-way ANOVA showed a significant difference in vertical fracture resistance between the groups(P＜0.05), and LSD analysis showed that the GuttaFlow Bioseal-filled sample teeth were significantly more resistant to vertical fracture than the iRoot SP when using the thermal vertical compression filling method and the single-tip method(P＜0.05). In contrast, the GuttaFlow BIoseal-filled group was significantly less resistant to vertical fracture than the iRoot SP group when using the cold lateral compression filling method(P＜0.05).
CONCLUSIONS: GuttaFlow Bioseal has the potential to improve root resistance to vertical fracture when filling root canals using the thermal vertical pressurization method and the single-tip method, but more clinical trials are needed to validate this result and its long-term prognosis.

OBJECTIVE: Using X-ray micro-computed tomography (micro-CT), the aim of this study was to measure the porosity of two tricalcium silicate sealers (EndoSequence BC and NeoSealer Flo) applied using three obturation techniques (single-cone, warm-vertical, and cold-lateral) to six single-rooted human teeth.
METHODS: Six extracted, single-rooted human teeth were shaped with ProTaper Next rotary files and obturated with EndoSequence BC or NeoSealer Flo sealers and gutta-percha (GP) using one of the three techniques above. Micro-CT was used to map the full length of the canals. Deep learning cross-sectional segmentation was used to analyze image slices of the apical (0-2 mm) and coronal (14-16 mm from the apex) regions (n = 230-261 per tooth) for the areas of GP and sealer, as well as porosity. Median (%) with interquartile range of porosity were calculated , and the results were statistically analyzed with the Kruskal-Wallis test.
RESULTS: In the apical region, EndoSequence BC had significantly fewer pores than NeoSealer Flo with the single-cone obturation (% median-interquartile range, IQR: 0.00-1.62) and warm-vertical condensation (5.57-10.32) techniques, whereas in the coronal region, NeoSealer Flo had significantly fewer pores than EndoSequence BC with these two techniques (0.39-5.02) and (0.10-0.19), respectively. There was no significant difference in porosity between the two sealers for the cold-lateral condensation technique in both the apical and coronal regions.
CONCLUSIONS: For optimal obturation, the choice of technique and sealer is critical.

Presently, there is a significant focus on the investigation and advancement of polymer-modified asphalt that is both high-performing and environmentally sustainable. This study thoroughly examined the performance and modification mechanism of gutta-percha (GP) as a novel asphalt modifier. The investigation was conducted using a combination of macro- and microscopic testing, as well as molecular dynamics simulations. This work primarily examined the compatibility of GP with asphalt molecular modeling. This paper used molecular dynamics to identify the most suitable mixing temperature. Next, the gray correlation theory was used to discuss the most effective method for preparing gutta-percha-modified asphalt (GPMA). The macro-rheological tests and microscopic performance analysis provided a full understanding of the impact of GP on asphalt properties and the process of alteration. The findings indicate that eucommia ulmoides gum (EUG) exhibits good compatibility with asphalt, while sulfur-vulcanized eucommia ulmoides gum (SEUG) does not demonstrate compatibility with asphalt. Both EUG and SEUG enhance the thermal stability and resistance to deformation of asphalt at high temperatures, with SEUG having a particularly notable effect. However, both additives do not improve the resistance of asphalt to cracking at low temperatures. The manufacturing method for EUG-modified asphalt (EUGMA) involves physical mixing, whereas sulfur-vulcanized eucommia ulmoides gum-modified asphalt (SEUGMA) involves physical mixing together with certain chemical processes. This research establishes a theoretical foundation for the advancement of GP as a novel environmentally friendly and highly effective asphalt modification.

BACKGROUND: This study aimed to assess the quality of various obturation techniques to fill perforation caused by internal root resorption using Micro-computed Tomography.
METHODS: Cone-beam computed tomography images of a maxillary central incisor tooth with perforating internal resorptive defect were used to create a 3D printed model of the affected tooth. The replicas were divided into four groups based on the obturation technique used. The techniques included Group 1: a polydimethylsiloxane-based sealer (GuttaFlow-2) with gutta-percha. Group 2: same as Group 1 except for using a pre-mixed Bioceramic-based sealer (NeoSEALER Flo). Group 3: the defect was filled entirely using the NeoSealer Flo Bioceramic-based sealer. Group 4: the samples were obturated using the warm vertical compaction technique with a resin-based sealer (ADSeal). The resin models were then scanned a micro-computed scanner to evaluate the percentage of voids in each group.
RESULTS: The results showed that NeoSEALER Flo groups had significantly the highest volume of voids while GuttaFlow-2 and warm vertical compaction groups had the lowest void volume.
CONCLUSIONS: GuttaFlow-2 and warm vertical compaction techniques performed best in filling the internal resorptive defect.

BACKGROUND: Gutta-percha (GP) combined with an endodontic sealer is still the core material most widely used for tridimensional obturation. The sealer acts as a bonding agent between the GP and the root dentinal walls. However, one of the main drawbacks of GP core material is the lack of adhesiveness to the sealer. ZnO thin films have many remarkable features due to their considerable bond strength, good optical quality, and excellent piezoelectric, antibacterial, and antifungal properties, offering many potential applications in various fields. This study aimed to explore the influence of GP surface\'s functionalization with a nanostructured ZnO thin film on its adhesiveness to endodontic sealers.
METHODS: Conventional GP samples were divided randomly into three groups: (a) Untreated GP (control); (b) GP treated with argon plasma (PT); (c) Functionalized GP (PT followed by ZnO thin film deposition). GP\'s surface functionalization encompassed a multi-step process. First, a low-pressure argon PT was applied to modify the GP surface, followed by a ZnO thin film deposition via magnetron sputtering. The surface morphology was assessed using SEM and water contact angle analysis. Further comprehensive testing included tensile bond strength assessment evaluating Endoresin and AH Plus Bioceramic sealers\' adhesion to GP. ANOVA procedures were used for data statistical analysis.
RESULTS: The ZnO thin film reproduced the underlying surface topography produced by PT. ZnO thin film deposition decreased the water contact angle compared to the control (p < 0.001). Endoresin showed a statistically higher mean bond strength value than AH Plus Bioceramic (p < 0.001). There was a statistically significant difference between the control and the ZnO-functionalized GP (p = 0.006), with the latter presenting the highest mean bond strength value.
CONCLUSIONS: The deposition of a nanostructured ZnO thin film on GP surface induced a shift towards hydrophilicity and an increased GP\'s adhesion to Endoresin and AH Bioceramic sealers.

Identifying the presence, size, type and location of voids in an endodontic obturation is of great clinical importance because it enables evaluation of the three-dimensionality of the sealing techniques, which can be related to the success of the endodontic treatment.
To analyze by micro-CT the presence of voids in lower single-rooted premolar root canal obturations prepared using the single cone and ultrasound vibration technique.
Twenty extracted single-rooted lower premolars were selected, and the root canal prepared surgically and chemically. In GROUP 1 - Without Vibration, the canal was obturated with a single cone and bioceramic, without applying vibration. In GROUP 2 - With Vibration, the gutta-percha cone inside the root canal was held with a cotton plier to which ultrasound vibration was applied for 3 periods of 3 seconds each. A micro-CT scanner was used to acquire and reconstruct images for analysis.
No significant difference was found between obturation techniques, though there were differences between thirds, with the cervical third having a higher percentage of voids than the middle and apical thirds.
The results suggest that the volume of closed, open and total voids does not differ between treatments with and without ultrasound vibration. In the cervical third, the highest volume of voids was related to oval geometry in the teeth evaluated.
La presencia de vacíos en la obturación endodóntica, su tamaño y el tipo y localización tiene gran importancia clínica ya que permite evaluar la tridimensionalidad de las técnicas de sellado y relacionarlas con el éxito del tratamiento endodóntico.
analizar mediante microtomografía la presencia de vacíos en la obturación del conducto radicular de premolares inferiores unirradiculares, utilizando la técnica de cono único y vibración con ultrasonido.
se seleccionaron 20 premolares inferiores unirradiculares a los que se les realizó la preparación quirúrgica y química del conducto radicular. Se realizó la obturación con cono único y biocerámico GRUPO 1- sin vibración. En el GRUPO 2 - con vibración se aplicó vibración por ultrasonido, se tomó del cono de gutapercha colocado en el interior del conducto con pinza de algodón que fue vibrada durante 3 períodos de 3 segundos cada uno. Las mismas fueron adquiridas y reconstruidas en un microtomógrafo para posterior análisis de las imágenes obtenidas.
No se evidenciaron diferencias significativas entre ambas técnicas de obturación comparadas, pero si entre los tercios analizados, siendo el cervical el que mayor porcentaje de vacíos presenta en comparación a los cortes correspondientes al tercio medio y apical.
Los resultados sugieren que el volumen de vacíos cerrados, abiertos y total no varía en los tratamientos donde se aplica vibración por ultrasonido. En el tercio cervical, el mayor volumen de vacíos se relaciona con la geometría oval que presentaron las piezas dentarias evaluadas en este estudio.

To investigate the efficacy of 3 root canal sealants such as AH Plus, GuttaFlow and iRoot SP combined with warm gutta-percha vertical compression technique in the treatment of dental pulp disease. This was a single-center retrospective study. 180 patients with dental pulp disease were divided into AH Plus group (n = 60), GuttaFlow group (n = 60) and iRoot SP group (n = 60) according to the different treatment methods. Patients in different groups were treated with corresponding root canal sealant combined with warm gutta-percha vertical compression technique. The quality of root canal filling, filling time, filling area ratio, the incidence of pain after operation, serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) and efficacy at 6 months after operation were compared among the 3 groups, respectively. The filling time in the GuttaFlow group and the iRoot SP group was significantly shorter than that in the AH Plus group (P < .001). There were significant differences in pain grade (P = .015) and pain rate (P = .016) among the 3 groups, and the pain rate in the GuttaFlow group and the iRoot SP group was significantly lower than that in the AH Plus group (P = .016). The time-point effect, intergroup effect and time-groups effect of serum TNF-α and IL-6 were significantly different (P < .001), and the levels of the 3 groups after treatment were significantly lower than those before treatment (P < .05), and the levels were significantly lower in the GuttaFlow group and the iRoot SP group (P < .05). There were significant differences in efficacy grading and effective rate among the 3 groups (P = .028), and the effective rate of iRoot SP group was significantly higher than that of AH Plus group (P < .05). The iRoot SP or GuttaFlow as root canal sealant combined with warm gutta-percha vertical compression technique in the treatment of dental pulp disease is better than AH Plus, and the former one can shorten the filling time, relieve the postoperative pain and improve the inflammatory response, but the long-term apical sealing effect of iRoot SP is better than GuttaFlow.

OBJECTIVE: Post-operative pain may occur after non-surgical root canal treatment (NSRCT). The root filling technique and choice of sealer may be contributing factors. This randomized controlled clinical trial compared post-operative pain and analgesics intake after NSRCT using a sealer-based obturation technique (SBO) with single-cone gutta-percha and calcium silicate sealer (CSS) versus a warm-vertical compaction (WVC) technique with gutta-percha and a resin-based sealer (RBS).
METHODS: This study was designed as a parallel-two arm, double-blind, randomized superiority clinical trial registered at www.
RESULTS: gov (NCT04753138). Patients referred for NSRCT fulfilling the inclusion criteria participated in this study. Pre-operative periapical radiographs and CBCT scans were taken and numerical rating scale (NRS) pain scores were recorded. Upon completion of canal instrumentation, participants were randomly allocated to either Group SBO: SBO with CSS or Group WVC: Warm-vertical compaction with RBS. Post-operative pain and analgesics intake were recorded at 1, 3 and 7 days after endodontic treatment completion. Non-parametric Mann-Whitney U and Friedman tests and a generalized estimating equation were used to assess differences in pain scores between the groups, within each treatment group at different time points and for correlations, respectively.
RESULTS: The study included 195 participants (212 teeth). One participant declined to submit the NRS form. Therefore, 194 participants (211 teeth) were included in the final analysis (99.5% response rate). No statistically significant differences in post-operative pain or analgesic intake existed between the two groups at any time point (p > .05). Age, pre-operative pain, apical diagnosis and post-operative analgesic intake were significantly related to post-operative pain (p < .05).
CONCLUSIONS: Sealer-based obturation technique with CSS was associated with similar post-operative pain levels and analgesics intake as WVC with RBS. Regarding post-operative pain, SBO with CSSs may be a suitable clinical alternative.

OBJECTIVE: A systematic review and meta-analysis of the literature was carried out assessing the success rate of root canal retreatment using gutta percha.
METHODS: Four of the largest databases were used to identify existing literature with no date or language restrictions. PubMed, Cochrane, ScienceDirect, Scopus and other additional sources were searched. Grey literature was also reviewed.
METHODS: Two authors, with Master\'s degrees in endodontics and with extensive university teaching experience, were selected to screen the databases to identify suitable studies. In case the authors were not able to agree during the study selection process, a third investigator was consulted. Specific inclusion and exclusion criteria were outlined and adhered to in the study selection. Two randomised controlled trials, seven single arm prospective studies and one single arm ambispective study published before the 10th of December 2022 were included. These studies evaluated the success of root canal re-treatment, obturated with gutta percha with at least a 1-year follow-up. Nine of the studies were published between 1998 and 2022. Seven studies were conducted in Europe, one in North America and one in Asia.
METHODS: Standard Cochrane methods to assess interval validity were used. Risk of bias in individual studies was assessed using The Newcastle-Ottawa quality assessment scale (NOS) for single-arm studies, and the Cochrane risk of bias tool (RoB2) was used for randomised controlled trials. Outcome measures were standardised as either success or failure of root canal retreatment. Success was classified into 2 different criteria: Strict criteria = absence of clinical signs and symptoms and radiographically normal periodontal ligament space; and Loose criteria = absence of clinical signs and symptoms and absence or reduction of apical radiolucency in the control radiograph. Statistical analysis was undertaken using R software and the Freeman-Turkey transformation was performed. Results were visualised using forest plots. Heterogeneity between studies was measured using the Cochrane Q test and I2 values.
RESULTS: Whilst following strict criteria, the success rate of non-surgical root canal retreatment obturated with gutta percha was 71% for 1-3 years follow-up (95% CI, 0.66-0.77) and 77% for 4-5 years follow-up (95% CI, 0.67-0.86). Heterogeneity was moderate (I2 = 61.4) and low (I2 = 0.0), respectively. Factors reducing the success rate of root canal re-retreatment under the strict criteria were older patients, mandibular teeth, molar teeth, the presence of a peri-apical radiolucency, teeth with a previous radiolucency, large peri-apical radiolucency\'s, higher initial periapical index scores and multiple visit-retreatments. Following the loose criteria, the success rate of non-surgical root canal re-treatment obturated with gutta percha was 87% for 1-3 years follow-up (95% CI, 0.79-0.93) with significant heterogeneity across the studies (I2 = 88.5%). Factors influencing the success rate under the loose criteria were large periapical lesions >5 mm and higher initial periapical index (PAI) scores.
CONCLUSIONS: Non-surgical root canal retreatment results in favourable outcomes. However, there are several factors which can result in a lower success rate: the presence and size of a periapical radiolucency, a higher initial PAI score, multiple-visit retreatments, and the size and position of the tooth.