Bioceramic Immediate Wash Out (BIWO) and Immediate Build Up (IBU) of Endodontically Treated Teeth: Proof of Concept

Source abstract

Background: The aim of this study was to find out a combination between the endodontic treatment and the restorative procedure to be performed in one step. For that, the validity of a combined warm vertical condensation technique, an immediate washout of the bi-oceramic sealer (Bioceramic Immediate Wash Out, BIWO), and an immediate build-up (IBU) of the endodontically treated tooth was evaluated. Methods: One hundred ten single-root human teeth were selected. Then, the sample roots were divided into 3 Groups according to the used the endodontic sealer and the wash out technique: Group 1. CeraSeal root canal sealer with the continuous wave of condensation technique (CWC), BIWO and IBU; Group 2. Ceraseal with a week delayed BDWO (Bioceramic Delayed Wash Out, BDWO) and a delayed build-up (DBI); Group 3. Pulp Canal Sealer EWT (PCS) with the BIWO and IBU; Restorations were made with a fiber post or using a fiber re-inforced flowable resin composite. The samples were tested by push out and SEM ob-servation to evaluate the cleanliness of root canal walls. Also, apical leakage test was performed to evaluate if BIWO might negatively affect the apical seal. Results: Group 1 post scored the highest values (15.23 ± 4.2 MPa), followed closely by Group 1 composite (14.51 ± 3.1 MPa), and then Group 2 post (12.83 ± 3.1 MPa), and Group 2 composite (12.52 ± 2.1 MPa). The lowest values were recorded for Group 3 post (9.55±1.32) and Group 3 composite (9.12±1.67). Statistically significant differences were detected among these Groups (p > 0.05). Regarding the influence of sealer type, the groups obturated with BES (Group 1 and 2) demonstrated significantly higher bond strength values than those obturated with Pulp Canal Sealer (p < 0.05). From the SEM observation was evident that the BIWO technique obtained a better cleaned dentin surface from the smear layer. The apical leakage test did not show any differences among BIWO and BDWO, and BES and PCS. Conclusions: From the findings of this in vitro study, the following conclusions can be drawn: 1. The BIWO is more effective than BDWO. 2. The BIWO achieved clean dentinal wall surfaces, available for bonding. 3. The BIWO dos not affect the apical seal of the endodontic obturation.