|Year : 2019 | Volume
| Issue : 3 | Page : 74-76
Activ GP system in endodontics: A review
Mazen Doumani1, Adnan Habib2, Razan O Khallof1, Mohammad I Albakheet3, Mohammed G Alghamdi3, Turki I Alowyyed2
1 Department of Restorative Dental Sciences, Alfarabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
2 Department of Restorative Dental Sciences, College of Dentistry, Buraydah, Saudi Arabia
3 Ministry of Health, Riyadh, Saudi Arabia
|Date of Submission||07-Oct-2019|
|Date of Acceptance||08-Oct-2019|
|Date of Web Publication||01-Jul-2019|
Dr. Mazen Doumani
Division of Restorative Dentistry and Endodontics, Department of Conservative Dentistry, Alfarabi College of Dentistry and Nursing, Riyadh.
Source of Support: None, Conflict of Interest: None
The ideal endodontic obturating material must cut communication between the root canal and the periodontal tissues. It should also be nongenotoxic, non-carcinogenic, nontoxic, biocompatible with host tissues, insoluble in tissue fluids, and dimensionally stable. Because the available root canal filling materials do not have these ideal properties, Activ GP system was developed and recommended to be used as a root canal filling material. The use of a new material should be based on laboratory, biological, and clinical studies. The aim of this review was to update previously published information and present a list of articles from various highly indexed endodontic journals regarding Activ GP system, cytotoxicity, pH, solubility, anti-biofilm activity, sealing properties, resistance to fracture of dental roots obturated with Activ GP system, retreatment, and the effect of irrigating solutions on bond strength of this system.
Keywords: Activ GP, cytotoxicity, fracture, sealing ability, solubility
|How to cite this article:|
Doumani M, Habib A, Khallof RO, Albakheet MI, Alghamdi MG, Alowyyed TI. Activ GP system in endodontics: A review. Int J Oral Care Res 2019;7:74-6
|How to cite this URL:|
Doumani M, Habib A, Khallof RO, Albakheet MI, Alghamdi MG, Alowyyed TI. Activ GP system in endodontics: A review. Int J Oral Care Res [serial online] 2019 [cited 2019 Dec 12];7:74-6. Available from: http://www.ijocr.org/text.asp?2019/7/3/74/261653
| Introducing the Activ GP Precision Obturation System According to the Manufacturers|| |
Precise endodontics requires matching between the file and the master cone. The sizes of Activ GP Gutta percha cones are consistently accurate and verified by laser measurement to match any constant taper .04 or .06 file system. There are two types of Gutta percha in this obturation system: the first one is Activ GP Plus, which uses calibration rings for easy depth measurement and a unique barrel handle, which when placed with placement instrument facilitates easy placement into the canal, whereas the second type of Gutta percha is Activ GP that uses a traditional Gutta percha design. Special technology fuses glass ionomer particles into the Gutta percha point. Another process applies an adhesive layer of particles to the surface of the Gutta percha. The result is a highly active surface prepared to chemically adhere to the Activ GP glass ionomer sealer. The sealer accompanied with this system is glass ionomer sealer; it has been developed with an extended 12-min working time, this sealer does not need a long rinsing of the canal to ensure set or adhesion. The ionic bond of glass ionomer to dentin means there is no need for a bonding agent and the correlated application technique challenges. Chemical and micromechanical adhesion between the canal walls, the Activ GP sealer, and the Activ GP Gutta percha cones results in a monobloc (this is very significant because a true monobloc will allow us, for the first time, to create a hermetic seal within the root canal space) within the canal, completely sealing the canal from orifice to apex. Plus, the closely matched accuracy of the Activ GP Gutta percha points to the EndoSequence files’ tapered preparation that minimizes the amount of sealer and any associated material shrinkage. Activ GP system’ sealer which is glass ionomer based; is highly radiopaque, this makes treatment realizing easy. Glass ionomer responds well in the presence of sodium hypochlorite, but resins and their bonding capability are adversely affected by exposure to the bleach sodium hypochlorite.
| Activ GP System Characteristics According to Different Published Studies|| |
Cytotoxicity of Activ GP sealer (Glass ionomer based sealer)
Donadio et al. (2009) reported that Activ GP sealer was moderately toxic when freshly mixed and less toxic when set. Karapinar-Kazandağ et al. (2011) found that undiluted eluates of Activ GP were found to be severely cytotoxic, whereas 25% of diluted eluates were not cytotoxic, suggesting that cytotoxicity is a dose-dependent phenomenon.
pH, solubility, and anti-biofilm activity of Activ GP sealer
Cinar et al. (2009) and Faria-Júnior et al. (2013) found that Activ GP had a low pH at all evaluation periods. Faria-Júnior et al. (2013) reported that Activ GP sealer had a high solubility both at 2 days and 7 days after manipulation: 12.54% and 8.26%, respectively.8 This last result was similar to that of Flores et al. (2011). Among the seven materials evaluated including Activ GP sealer, only two—Sealapex and MTA Fillapex—had anti-biofilm activity against Enterococcus faecalis.
Sealing properties of Activ GP system
Monticelli et al. (2007) reported the observation of fairly extensive silver penetration within the ActiV GP sealer, which suggested that similar to other glass–ionomer sealers, this sealer is susceptible to water sorption and leaching, and concluded that Activ GP System produced apical seals that are comparable with that of warm vertical compaction of Gutta percha using AH Plus sealer. Also, Joel et al. (2008) reached the same result as that of Monticelli et al. but by using bacterial leakage. Karapınar-Kazandag et al. reached the filling materials (Resilon–Epiphany, EndoRez, Activ GP, and conventional AH Plus–Gutta percha technique using the glucose filtration model) with the monobloc concept do not seem to be superior to the conventional AH Plus + Gutta percha system regarding microleakage, and this result was similar to different other studies. The study of Royer et al. (2013) declared that glass ionomer–based Activ GP was comparable to a vertical compaction of warm Gutta percha plus Zinc Oxide Eugenol Root Canal Sealer (EWT sealer) (liquid: eugenol and powder: zinc oxide, Staybelite resin, bismuth subcarbonate, barium sulfate, and sodium borate anhydrate) in sealing root canal spaces. Kassar et al. (2018) reported that dye penetration examination showed that Activ GP/Glass Ionomer sealer had weak sealing properties to root canal walls in comparison with GP/AH Plus and Resilon/Real Seal, and lateral condensation obturation technique showed better sealing properties in comparison with single cone technique.
Resistance to fracture of dental roots obturated with Activ GP system
Celikten et al. (2015) concluded that glass ionomer–based sealer and cone (Activ GP obturation system), bioceramic sealer and cone (EndoSequence BC obturation system), and bioceramic sealer and cone (Smartpaste bio obturation system) showed resistance to fracture similar to sound tooth; however, all the obturation materials used in this study increased the fracture resistance of instrumented root canals. Doumani et al. (2017) reported a different result comparing with the last study, so they mentioned that Activ GP system did not exert a significant effect on the fracture resistance of endodontically treated teeth. Angie et al. (2011) concluded that bioceramic-based sealer (i.e., iRoot SP) is a promising sealer in terms of increasing in vitro resistance to the fracture of endodontically treated roots particularly when accompanied with Activ GP cones.
Effect of irrigating solutions on bond strength of Activ GP system
Dentin surface treatment with different irrigation regimens may cause alteration in the chemical and structural composition of human dentin, thereby changing its permeability and solubility characteristics,, and hence affecting the adhesion of materials to dentin surfaces. Hashem et al. reached that bonding strength of Activ GP Glass Ionomer sealer can be improved by final irrigation with 17% ethylenediaminetetraacetic acid (EDTA) followed by 2% Chlorhexidine (CHX), CHX does not enhance the effect of Mixture tetracycline citric acid and detergent (MTAD) on Activ GP bond strength, and the bond strength of GP/AH plus was adversely affected by MTAD and MTAD/CHX. In the same study by Hashem et al., final irrigation with EDTA resulted in higher bond strength values for GP/AH plus than that for Activ GP, which was consistent with that of another study.
Efficacy of rotary retreatment instrumentation to remove Activ GP system
One of the properties of sealers most probably related to their ease of removal is adhesion to dentine. Activ GP sealer is expected to bond to dentine. When using gross radiographic criteria, Activ GP was more effectively removed from the root canals than AH Plus with hand instrumentation. Hybrid Root SEAL, EndoSequence BC Sealer, and AH Plus could be removed to a similar extent. Irrespective of the sealer type and retreatment technique, the filling material could not be removed completely from the root canals, and significantly more remaining filling material was observed in the apical third. ProTaper Universal retreatment instruments were as safe and effective as hand instruments in reaching the working length.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Available from: https://www.dentistryiq.com/clinical/endodontics/article/16348349/introducing-the-activ-gp-precision-obturation-system. [Last accessed on 2019 June 5].
Available from: www.realworldendo.com. [Last accessed on 2019 June 5].
Available from: https://brasselerusa.com/. [Last accessed on 2019 June 5].
Donadio M, Jiang J, He J, Wang YH, Safavi KE, Zhu Q. Cytotoxicity evaluation of Activ GP and Resilon sealers in vitro
. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:e74-8.
Karapınar-Kazandağ M, Bayrak OF, Yalvaç ME, Ersev H, Tanalp J, Sahin F, et al
. Cytotoxicity of 5 endodontic sealers on L929 cell line and human dental pulp cells. Int Endod J 2011;44:626-34.
Susini G, About I, Tran-Hung L, Camps J. Cytotoxicity of epiphany and Resilon with a root model. Int Endod J 2006;39:940-4.
Cinar C, Ulusu T, Ozçelik B, Karamüftüoğlu N, Yücel H. Antibacterial effect of silver-zeolite containing root-canal filling material. J Biomed Mater Res B Appl Biomater 2009;90:592-5.
Faria-Júnior NB, Tanomaru-Filho M, Berbert FL, Guerreiro-Tanomaru JM. Antibiofilm activity, pH and solubility of endodontic sealers. Int Endod J 2013;46:755-62.
Flores DS, Rached FJ Jr, Versiani MA, Guedes DF, Sousa-Neto MD, Pécora JD. Evaluation of physicochemical properties of four root canal sealers. Int Endod J 2011;44:126-35.
Monticelli F, Sword J, Martin RL, Schuster GS, Weller RN, Ferrari M, et al
. Sealing properties of two contemporary single-cone obturation systems. Int Endod J 2007;40:374-85.
Carvalho-Júnior JR, Guimarães LF, Correr-Sobrinho L, Pécora JD, Sousa-Neto MD. Evaluation of solubility, disintegration, and dimensional alterations of a glass ionomer root canal sealer. Braz Dent J 2003;14:114-8.
Joel N, Jianing He, Gerald N, Glickman GN, Rios A, Shulman JD. Comparative assessment of ActiV GP/glass ionomer sealer, Resilon/Epiphany, and Gutta-Percha/AH Plus obturation: A bacterial leakage study. JOE 2008;34:725-7.
Karapınar-Kazandağ M, Tanalp J, Bayrak ÖF, Sunay H, Bayırlı G. Microleakage of various root filling systems by glucose filtration analysis. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics. 2010;109:96-102.
Monticelli F, Sadek FT, Schuster GS, Volkmann KR, Looney SW, Ferrari M, et al
. Efficacy of two contemporary single-cone filling techniques in preventing bacterial leakage. J Endod 2007;33: 310-3.
Royer K, Liu XJ, Zhu Q, Malmstrom H, Ren YF. Apical and root canal space sealing abilities of resin and glass ionomer-based root canal obturation systems. Chinese J Dent Res 2013;16:47-53.
Kassar SA, Habib AA, Doumani MD, Abdulrab S, Alafif H. Evaluation of apical sealing ability of ActiV GP/glass ionomer sealer as a root filling material. Endodontology 2018;30:113-8. [Full text]
Celikten B, Uzuntas CF, Gulsahi K. Resistance to fracture of dental roots obturated with different materials. BioMed Res Int 2015:1-5.
Mazen D, Abdulrab S, Samran AA, Doumani A, Layous K, Özcan M. Influence of different obturation systems on the fracture resistance of endodontically treated roots. Braz Dent Sci 2017;20:6-11.
Ghoneim AG, Lutfy RA, Sabet NE, Fayyad DM. Resistance to fracture of roots obturated with novel canal-filling systems. JOE 2011;37:1590-2.
Van Meerbeek B, Lambrechts P, Inokoshi S, Braem M, Vanherle G. Factors affecting adhesion to mineralized tissues. Oper Dent 1992;5:111-24.
Doğan H, Qalt S. Effects of chelating agents and sodium hypochlorite on mineral content of root dentin. J Endod 2001;27:578-80.
Erickson RL. Surface interactions of dentin adhesive materials. Oper Dent 1992;5:81-94.
Hashem AA, Ghoneim AG, Lutfy RA, Fouda MY. The effect of different irrigating solutions on bond strength of two root canal–filling systems. JOE 2009;35:537-40.
Fisher MA, Berzins DW, Bahcall JK. An in vitro
comparison of bond strength of various obturation materials to root canal dentin using a push-out test design. J Endod 2007;33:856-8.
Só MV, Saran C, Magro ML, Vier-Pelisser FV, Munhoz M. Efficacy of ProTaper retreatment system in root canals filled with gutta-percha and two endodontic sealers. J Endod 2008;34:1223-5.
Koch K, Brave D. Activ GPTM: A single-cone obturation technique. Inside Dent 2006;2:76-7.
Ersev H, Yilmaz B, Dinçol ME, Dağlaroğlu R. The efficacy of ProTaper Universal rotary retreatment instrumentation to remove single gutta-percha cones cemented with several endodontic sealers. Int Endod J 2012;45:756-62.