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Title Comparison of Endodontic Sealers With Or Without Bactericidal Effect
Clinical Question Are endodontic sealers with bactericidal properties more effective at treating root canals than those without bactericidal properties?
Clinical Bottom Line There is insufficient evidence to determine definitively. No available research focuses on the clinical outcome of using a bactericidal or non bactericidal sealer. Of the in vitro studies available Vcanalare showed the longest lasting anti-microbial activity. It appears from the outcome studies found on root canal treatment in general, the materials used were not important to long term success so long as modern techniques were applied. More clinical trials should be conducted in order to determine the most affective means of sealing a root canal cleaning and shaping. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 19840638Tsesis/2009Human permanent teeth, all ages all gendersMeta-Analysis
Key resultsA successful outcome in a follow-up of more than 1 year post-operatively was 91.6%. Age, gender, tooth type, root-end filling material, and magnification type had no significant effect on the proportion of success. CONCLUSIONS: Surgical endodontic treatment done by using a modern technique is a predictable treatment.
#2) 9587273Giuseppe Pizzoa/2005Extracted teethComparative Study
Key resultsThe anti-microbial activity of the tested sealers depends on the time interval between mixing and testing. All sealers exhibit bactericidal effect when freshly mixed, but only Vcanalare extended this effect until 7 days after setting.
#3) 17931389Ng/2007In Vivo Permanent teeth. Systematic Review
Key resultsThere was substantial variation in the study-designs. It would be desirable to standardize aspects of study-design, data recording and presentation format of outcome data in the much needed future outcome studies.
Evidence Search antimicrobial"[All Fields] AND "Root Canal Therapy"[Mesh] AND "sealer"[All Fields]("root canal therapy"[MeSH Terms] OR ("root"[All Fields] AND "canal"[All Fields] AND "therapy"[All Fields]) OR "root canal therapy"[All Fields]) AND ("humans"[MeSH Terms] AND Meta-Analysis[ptyp]
Comments on
The Evidence
There is insufficient evidence available on the subject currently.
Applicability The studies available are not focused enough to answer questions based on the materials used during the treatment.
Specialty/Discipline (Endodontics)
Keywords Root Canal Therapy, Bacteriocidal, endodontic, sealer
ID# 546
Date of submission: 03/29/2010spacer
E-mail windhamc@livemail.uthscsa
Author Clayton Paul Windham
Co-author(s) e-mail
Faculty mentor/Co-author Adriana V. Green, DDS, MPH
Faculty mentor/Co-author e-mail greenav@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
post a comment
by Nicole Nellis (San Antonio, TX) on 04/18/2012
I performed a PubMed search in April 2012 and I found a more recent publication: PubMed ID: 21273712. This is an in vitro study that found that zinc oxide eugenol endodontic sealers produce the greatest inhibition of bacterial growth when tested against seven different strains of bacteria. This study adds further documentation to this CAT, but there are still no studies that show whether bactericidal endodontic sealers are more effective than sealers without bactericidal properties.
by Philip T. Reynolds, DDS (Center, TX) on 06/28/2011
I have found that the success of endodontic treatment in my practice has not changed or been affected by the type of sealer that I use. The better my technique, the more successful that outcome of treatment.

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