ION RELEASE FROM PROTOTYPE

SURFACE PRE-REACTED GLASS IONOMER

SEALER AND ENDO SEQUENCE BC
SEALER

Bhat A, Cvach N, Mizuno C, Ahn C, Zhu Q, Primus C, Komabayashi T. Ion Release From Prototype Surface Pre-
Reacted Glass Ionomer Sealer and EndoSequence BC Sealer. European Endodontic Journal. 2021;6(1):122.
INTRODUCTION
• Zirconium oxide,
• Calcium silicates,
• Calcium phosphate,
• Calcium hydroxide,
• Thickening agents.
 Powder:

Zinc oxide-based inorganic compound filler,

SURFACE PRE Surface reaction-type pre-reacted glass ionomer (S-PRG) filler,
REACTED GLASS Unknown additives.

IONOMER SEALER (S- Liquid :

PRG) Polycarboxylic acid-derived, Water,

Unknown additives
• Fluoride ion - remineralization,
• Strontium, boron, and silicon ions are
antibacterial and have osteogenic
potential
• Avoid collapse of the dentinal tubule
because of its neutral pH
• Silicon ions - promote bone formation
and tooth remineralization
 • Used to measure elements in
biological fluids and solids, including
teeth.
• It allows multiple elements to be
measured at the same time.
• The ICP converts elements into ions
which can be then detected by the
mass spectrometer.

Inductively coupled plasma mass

spectrometer
 COMPARATIVE BIOLOGICAL ASSESSMENTS OF ENDODONTIC
ROOT CANAL SEALER CONTAINING SURFACE PRE-REACTED
GLASS-IONOMER (S-PRG) FILLER OR SILICA FILLER

AIM: To evaluate the antibacterial and anti-inflammatory properties of S-PRG sealer compared
with sealer containing conventional silica fillers (silica sealer).

• Antibacterial tests showed that S-PRG sealer significantly reduced the turbidity of enterococcus
faecalis compared with silica sealer.
• Implantation of S-PRG or silica sealer blocks in rat subcutaneous tissue showed that S-PRG
sealer decreased the proinflammatory response compared with silica sealer at 10 days post-
implantation

Miyaji H, Mayumi K, Miyata S, Nishida E, Shitomi K, Hamamoto A, et al. Comparative biological assessments of endodontic root canal sealer containing
surface pre-reacted glass-ionomer (S-PRG) filler or silica filler. Dent Mater J 2020; 39(2):287–94
• In addition, immunostaining revealed that infiltration of CD68- and peroxidase-
positive cells around the S-PRG sealer was significantly lower than that in silica
sealer.

• Therefore, it was suggested that S-PRG sealer exhibits antibacterial and anti-
inflammatory effects.
 EVALUATION OF THE IONS RELEASE / INCORPORATION OF THE
PROTOTYPE S-PRG FILLER CONTAINING ENDODONTIC SEALER

AIM: To evaluate a prototype surface reaction-type pre-reacted glass-ionomer (S-PRG) filler-

containing endodontic sealer (S-PRG sealer) in terms of its ion-releasing ability and the
incorporation of the released ions by root canal dentin.

40 bovine incisor roots were sectioned to 4 mm in length.

The canals of these cylindrical specimens were instrumented using a #140 k-file under copious
irrigation with 3% naocl.
These specimens were assigned to 2 groups, the S-PRG sealer group (n=20) and the control (pd)
group (n=20).

Han L, Okiji T. Evaluation of the ions release / incorporation of the prototype S-PRG filler-containing endodontic sealer. Dent Mater J 2011; 30(6):898–903.
• The results of this study suggest that S-PRG sealer releases a high amount of Sr,
F, B, and Si, consequently, produces a high-density ion-incorporation layer,
which seems to positively influence the formation of mineralized dentin tissue
 AIM

• To measure the release of boron, strontium, and silicon ions from surface pre-
reacted glass ionomer (S-PRG) filler containing prototype endodontic sealer over
a sustained period in comparison to Endosequence BC sealer in a simulated
clinical model using extracted human teeth in vitro.
METHODOLOGY
• Twelve extracted human teeth.

• Maxillary anterior, single-rooted, and without caries involving the root

• W.L - determined.

• Cleaned and shaped - Protaper next rotary file system (X3) by using promark torque-limited electric
motor.

• Teeth were irrigated with copious 2.5% NaOCl);

• No irrigant was used for smear layer removal.

• After instrumentation - 12 teeth 6 – S-PRG
6 – E - BC

• A consistent volume of sealer (approximately 1 mm3) was promptly applied to

completely cover the gutta-percha point within the standard working time.

• After the condensation & setting times, Cyanoacrylate adhesive – coronal

sealing before in vitro soaking.

 IN VITRO SOAKING OF TEETH
• The root canal filled teeth were soaked in sealed 1.5-ml polyethylene tubes filled
with 1 ml of PBS - 2 weeks (336 hours).
• Stored in a 37°c incubator.
• Samples (1-ml) were taken at 3, 6, 12, 24, 48, 120, 168, and 336 hours using a
manual pipette.
• Samples were obtained after first agitating the solution. 1ml of fresh PBS
solution was replaced post-sampling, and samples were stored in the incubator
between sampling intervals.
 ICP PROTOCOL
• B, Si, and Sr ion release -- inductively coupled plasma mass spectrometer.

• The icp-ms detected the absorbance wavelengths of the ions in the collected pbs.

• High-purity nitric acid and milliq water were used to prepare a 2% nitric acid
solution for sample and standard preparations.

• A standard mixture containing Si (50 μg/ ml), Sr, Na, B, and ca (each at 100
μg/ml) was used.
• 20-fold dilution of standard mixture with 2% nitric acid to 1/1000.

• The internal standard was lutetium (10000 μg/ml).

• Standards and samples were spiked with the internal standard of lutetium at a

concentration of 100 ng/ml

• PBS was diluted 20-fold with 2% nitric acid for use as a matrix blank.
• Matrix blanks, standard solutions, and samples were assayed in duplicate or

triplicate.

• Counts per second (cps) for each analyte of interest in the matrix blank were

subtracted from the standard and sample results for corresponding analytes.

• The absorbance wavelength was measured in ng/ml for each of the samples.

• All samples were measured in ng/ml within the pbs solution.

RESULTS
• Si > B & Sr

• Si (E-BC > S-PRG)

• B (S-PRG > E-BC)

• Sr (S-PRG > E-BC)

• Speed of B & Si = Similar

• Speed of Sr (Rapid initial

burst followed by slow
continuous for S-PRG)

• Slow and continuous – (E-BC)

 DISCUSSION

• The cumulative ion release of the two sealers was measured in this study.

• Neither the cementum nor the smear layer was removed.

• The antimicrobial effects of boron have been demonstrated on g+ and g- bacteria

in anaerobic environments.
 • Miyaji et al. demonstrated the efficacy of the S-PRG sealer against E. Faecalis,

G+ microbe, and found that, due to its release of antibacterial ions such as boron

and strontium, S-PRG sealer exhibited more significant antibacterial effects

against E. Faecalis than a silica-filled sealer

Miyaji H, Mayumi K, Miyata S, Nishida E, Shitomi K, Hamamoto A, et al. Comparative biological assessments of endodontic root canal sealer
containing surface pre-reacted glass-ionomer (S-PRG) filler or silica filler. Dent Mater J 2020; 39(2):287–94
 • Strontium ions - enhanced bone formation and strengthening in bone cement
containing bioactive glasses substituted with strontium.

• Kusaka et al. Reported increased osteogenesis around the S-PRG sealer in a bone
implantation study.

• Sasaki et al. Found increased levels of strontium ions, as seen in bioglass-

containing glass ionomer cement, had no cytotoxicity on osteoblasts and allowed
normal cellular proliferation.

Kusaka Y. Influence of Root Canal Sealer Containing S-PRG Filler on Osteogenesisin Tibia of Rats. J Meikai Dent Med 2018; (47)2;139–
47.
Sasaki JI, Kiba W, Abe GL, Katata C, Hashimoto M, Kitagawa H, et al. Fabricationof strontium-releasable inorganic cement by incorporation
ofbioactive glass. Dent Mater 2019; 35(5):780–8.
• Hong et al. Found there were no significant differences in bacterial diversity between

primary and persistent infections using pyrosequencing.

• Bacteroidetes was the most abundant phylum in both infections.

• The S-PRG sealer released fewer silicon ions over time when compared to the E-BC

sealer.

• Silicon is not known to be antimicrobial but has been shown to increase bone mass.

Hong BY, Lee TK, Lim SM, Chang SW, Park J, Han SH, et al. Microbial analysis in primary and persistent endodontic infections by
using pyrosequencing. J Endod 2013; 39(9):1136–40.
• Silicon plays a role in collagen synthesis = both bone formation and tooth remineralization

• Silicon ions from E-BC sealer -- tri/dicalcium silicate cement component.

• While tricalcium silicate sealers produce a more desirable apical seal than other types of

sealers, the setting time of tricalcium silicate sealers is much longer (>2 hours) compared

to that of S-PRG sealer (13 minutes).

• B and Sr ion release from the root apex in > Conc. over time contributes to antimicrobial

action in the S-PRG sealer, and the release of Si ions assists in bone formation and

mineralization effects.

• A sealer that can release ions with antimicrobial properties after placement --Periapical

healing and decrease endodontic failure.

 CONCLUSION
• The prototype S-PRG sealer released boron and strontium ions in higher
cumulative concentrations over 2 weeks compared to the endosequence bc sealer.
• Both the prototype S-PRG and Endosequence bc sealers released silicon ions,
although significantly more were eluted from the Endosequence bc sealer.
• Antimicrobial and osteogenic ion release from sealers is expected to positively
influence the post-treatment control of microbial infections and improve
periapical healing.
 REFERENCES
• Bhat A, cvach N, mizuno C, ahn C, zhu Q, primus C, komabayashi T. Ion release
from prototype surface pre-reacted glass ionomer sealer and endosequence BC
sealer. European endodontic journal. 2021;6(1):122.
• Miyaji h, mayumi k, miyata s, nishida e, shitomi k, hamamoto a, et al.
Comparative biological assessments of endodontic root canal sealer containing
surface pre-reacted glass-ionomer (S-PRG) filler or silica filler. Dent mater J
2020; 39(2):287–94.
• Han l, okiji t. Evaluation of the ions release / incorporation of the prototype S-
PRG filler-containing endodontic sealer. Dent mater J 2011; 30(6):898–903.
• Kusaka Y. Influence of root canal sealer containing S-PRG filler on
osteogenesisin tibia of rats. J meikai dent med 2018; (47)2;139–47.
• Sasaki ji, kiba w, abe gl, katata c, hashimoto m, kitagawa h, et al. Fabricationof
strontium-releasable inorganic cement by incorporation ofbioactive glass. Dent
mater 2019; 35(5):780–8.
• Hong by, lee tk, lim sm, chang sw, park j, han sh, et al. Microbial analysis in
primary and persistent endodontic infections by using pyrosequencing. J endod
2013; 39(9):1136–40.