ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title In a Patient Requiring Endodontic Therapy, The use of N2-Sargenti Paste Proves to be Much More Cytotoxic in Comparison with Other Endodontic Sealers
Clinical Question In a patient requiring endodontic therapy, does the use of N2-Sargenti paste prove more or less cytotoxic, when compared with other endodontic sealers.
Clinical Bottom Line In a patient requiring endodontic therapy, the use of N2-Sargenti paste proves to be much more cytotoxic in comparison with other endodontic sealers. This is supported by various short and long term experiments each concluding that N2 paste radically reduces cellular metabolism quantified in terms of mitochondrial activity.
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) 12470025Schwarze/200230, 10mL samples of cell culture medium.Laboratory study
Key resultsIn comparison with AH Plus, Apexit, Endomethason, and Ketac Endo, N2 thoroughly inhibited cellular metabolism for the duration of each trial when applied directly to the cell cultures.
#2) 12470017Schwarze/200224 roots of freshly extracted anterior and premolar teeth, in culture media.Laboratory study
Key resultsThe roots of N2-sealed teeth leach endodontic sealer during the setting period; Although most of the cellular changes occurred during the first 5 weeks, alterations to normal growth were exhibited 22 weeks after treatment. N2 sealer does not significantly damage the internal hard tissues of the tooth.
#3) 11556560Tai/2001Buccal and gingival fibroblasts.Laboratory study
Key resultsN2 proved to be significantly cytotoxic when compared with other endodontic sealers. In each of these three studies, 100% of the samples treated with Sargenti paste exhibited degradative cellular changes; compared with Apexit® which displayed a 93.7% mitochondrial activity after treatment, Sargenti paste resulted in a 4.4% mitochondrial activity.
Evidence Search (endodontic[All Fields] AND sealer[All Fields]) AND compatibility[All Fields]
Comments on
The Evidence
Validity: Each of the three articles were equally valid laboratory studies. Each treated the groups similar at the start, and completed the study to 100%. Each group was treated the same, and being a laboratory study there was no need for patient compliance and followup. There was no evidence of recall bias or competing interests for any of the studies. Perspective: The successful use of Sargenti paste is largely influenced by technique. It appears that this paste’s improper delivery is the reason for it’s lack of support in the American dental world. It was also for this reason that the studies and reports about this topic were confined to experimental analyses on cell cultures rather than patient populations.
Applicability The subjects in these studies were representative of dental patients. The treatment they received is also a feasible treatment to receive in a general dental practice. The use of Sargenti paste is justified for most endodontic situations. There are no contraindication to the use of this substance, however its misuse results in severe consequences; the high risk of tissue inflammation and degeneration are what primarily limits this products use, and makes other endodontic sealers a more reasonable alternative.
Specialty/Discipline (Endodontics) (General Dentistry)
Keywords Sargenti, N2 Paste, Endodontics, Endodontic sealer
ID# 2676
Date of submission: 03/13/2014spacer
E-mail leeed@livemail.uthscsa.edu
Author Elan Lee
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Ernest Valdez, DDS
Faculty mentor/Co-author e-mail valdeze@uthscsa.edu
Basic Science Rationale
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