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CC BY 4.0 · Eur J Dent 2022; 16(01): 195-201
DOI: 10.1055/s-0041-1735429
Original Article

Comparison of Dentinal Tubule Penetration between a Calcium Silicate-Based Sealer with Ultrasonic Activation and an Epoxy Resin-Based Sealer: A Study Using Confocal Laser Scanning Microscopy

Dani Song
1   Department of Conservative Dentistry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
,
Sung-Eun Yang
1   Department of Conservative Dentistry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
› Author Affiliations Funding This work was supported by a National Research Foundation of Korea grant funded by the Korean government (No. NRF-2019R1A2C1005247).
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Abstract

Objective The aim of this study was to compare the degree of dentinal penetration between an epoxy resin-based sealer applied by using two different filling methods and an ultrasonically activated calcium silicate-based sealer via confocal laser scanning microscopy (CLSM).

Materials and Methods Forty-five extracted permanent maxillary premolars with type II canals (Vertucci’s classification) were subjected to the experiment. The root canals were instrumented and distributed randomly into the following three groups: AH Plus + continuous wave technique (AHC group); AH Plus + single cone technique (AHS group); and Endoseal MTA + single cone technique with ultrasonic activation (EMS) group. Each sealer was labeled with rhodamine B dye to allow visualization under CLSM. The sealer penetration depth in each sample was observed at 2 mm and 5 mm from the apex by using CLSM. The data were statistically analyzed by using analysis of variance or Kruskal–Wallis H test according to normality of variable (α = 0.05).

Results In all groups, the maximum sealer penetration depth, mean fluorescence intensity, and sum fluorescence intensity values were higher at the 5-mm level than at the 2-mm level. At the 5-mm level, the EMS group showed the lowest value (p = 0.02). At the 2-mm level, there were no statistically significant differences among any of the groups. The AHC group showed higher values than the other groups, but there was no statistically significant difference in the apical area where access of instruments was difficult.

Conclusion The AHC group showed the highest dentinal tubule penetration, but had questionable filing efficacy in the apical area, which is of particular importance for the success of root canal treatment. Therefore, in areas such as the apical 2 mm of premolars with type II canals, which are difficult to access by using instruments such as heat carriers, other appropriate approaches may be required accordingly.

Keywords

calcium silicate-based sealer - epoxy resin-based sealer - CLSM analysis


Publication History

Article published online:
21 October 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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  • References

  • 1 DuLac KA, Nielsen CJ, Tomazic TJ. Ferrillo PJ Jr, Hatton JF. Comparison of the obturation of lateral canals by six techniques. J Endod 1999; 25 (05) 376-380
    CrossrefPubMedGoogle Scholar
  • 2 Wang Y, Liu S, Dong Y. In vitro study of dentinal tubule penetration and filling quality of bioceramic sealer. PLoS One 2018; 13 (02) e0192248
    CrossrefPubMedGoogle Scholar
  • 3 Duarte MAH, Ordinola-Zapata R, Bernardes RA. et al. Influence of calcium hydroxide association on the physical properties of AH Plus. J Endod 2010; 36 (06) 1048-1051
    CrossrefPubMedGoogle Scholar
  • 4 Gharib SR, Tordik PA, Imamura GM, Baginski TA, Goodell GG. A confocal laser scanning microscope investigation of the epiphany obturation system. J Endod 2007; 33 (08) 957-961
    CrossrefPubMedGoogle Scholar
  • 5 Patel DV, Sherriff M, Ford TRP, Watson TF, Mannocci F. The penetration of RealSeal primer and Tubliseal into root canal dentinal tubules: a confocal microscopic study. Int Endod J 2007; 40 (01) 67-71
    CrossrefPubMedGoogle Scholar
  • 6 Marciano MA, Guimarães BM, Ordinola-Zapata R. et al. Physical properties and interfacial adaptation of three epoxy resin-based sealers. J Endod 2011; 37 (10) 1417-1421
    CrossrefPubMedGoogle Scholar
  • 7 Marin-Bauza GA, Rached-Junior FJA, Souza-Gabriel AE, Sousa-Neto MD, Miranda CES, Silva-Sousa YTC. Physicochemical properties of methacrylate resin-based root canal sealers. J Endod 2010; 36 (09) 1531-1536
    CrossrefPubMedGoogle Scholar
  • 8 Jardine AP, Rosa RA, Santini MF. et al. The effect of final irrigation on the penetrability of an epoxy resin-based sealer into dentinal tubules: a confocal microscopy study. Clin Oral Investig 2016; 20 (01) 117-123
    CrossrefPubMedGoogle Scholar
  • 9 Lim ES, Park YB, Kwon YS, Shon WJ, Lee KW, Min KS. Physical properties and biocompatibility of an injectable calcium-silicate-based root canal sealer: in vitro and in vivo study. BMC Oral Health 2015; 15 (01) 129
    CrossrefPubMedGoogle Scholar
  • 10 Shin JH, Lee DY, Lee SH. Comparison of antimicrobial activity of traditional and new developed root sealers against pathogens related root canal. J Dent Sci 2018; 13 (01) 54-59
    CrossrefPubMedGoogle Scholar
  • 11 Ersahan S, Aydin C. Solubility and apical sealing characteristics of a new calcium silicate-based root canal sealer in comparison to calcium hydroxide-, methacrylate resin- and epoxy resin-based sealers. Acta Odontol Scand 2013; 71 (3-4) 857-862
    CrossrefPubMedGoogle Scholar
  • 12 Ordinola-Zapata R, Bramante CM, Graeff MSZ. et al. Depth and percentage of penetration of endodontic sealers into dentinal tubules after root canal obturation using a lateral compaction technique: a confocal laser scanning microscopy study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108 (03) 450-457
    CrossrefPubMedGoogle Scholar
  • 13 Balguerie E, van der Sluis L, Vallaeys K, Gurgel-Georgelin M, Diemer F. Sealer penetration and adaptation in the dentinal tubules: a scanning electron microscopic study. J Endod 2011; 37 (11) 1576-1579
    CrossrefPubMedGoogle Scholar
  • 14 Tedesco M, Felippe MCS, Felippe WT, Alves AMH, Bortoluzzi EA, Teixeira CS. Adhesive interface and bond strength of endodontic sealers to root canal dentine after immersion in phosphate-buffered saline. Microsc Res Tech 2014; 77 (12) 1015-1022
    CrossrefPubMedGoogle Scholar
  • 15 Bitter K, Paris S, Pfuertner C, Neumann K, Kielbassa AM. Morphological and bond strength evaluation of different resin cements to root dentin. Eur J Oral Sci 2009; 117 (03) 326-333
    CrossrefPubMedGoogle Scholar
  • 16 Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol 1984; 58 (05) 589-599
    CrossrefPubMedGoogle Scholar
  • 17 Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol 1971; 32 (02) 271-275
    CrossrefPubMedGoogle Scholar
  • 18 Kim Y, Kim BS, Kim YM, Lee D, Kim SY. The penetration ability of calcium silicate root canal sealers into dentinal tubules compared to conventional resin-based sealer: a confocal laser scanning microscopy study. Materials (Basel) 2019; 12 (03) 531
    CrossrefPubMedGoogle Scholar
  • 19 Kokkas AB, Boutsioukis ACh, Vassiliadis LP, Stavrianos CK. The influence of the smear layer on dentinal tubule penetration depth by three different root canal sealers: an in vitro study. J Endod 2004; 30 (02) 100-102
    CrossrefPubMedGoogle Scholar
  • 20 Mamootil K, Messer HH. Penetration of dentinal tubules by endodontic sealer cements in extracted teeth and in vivo. Int Endod J 2007; 40 (11) 873-881
    CrossrefPubMedGoogle Scholar
  • 21 Weis MV, Parashos P, Messer HH. Effect of obturation technique on sealer cement thickness and dentinal tubule penetration. Int Endod J 2004; 37 (10) 653-663
    CrossrefPubMedGoogle Scholar
  • 22 Bolles JA, He J, Svoboda KK, Schneiderman E, Glickman GN. Comparison of Vibringe, EndoActivator, and needle irrigation on sealer penetration in extracted human teeth. J Endod 2013; 39 (05) 708-711
    CrossrefPubMedGoogle Scholar
  • 23 Kara A Tuncer, Tuncer S. Effect of different final irrigation solutions on dentinal tubule penetration depth and percentage of root canal sealer. J Endod 2012; 38 (06) 860-863
    CrossrefPubMedGoogle Scholar
  • 24 Hammad M, Qualtrough A, Silikas N. Three-dimensional evaluation of effectiveness of hand and rotary instrumentation for retreatment of canals filled with different materials. J Endod 2008; 34 (11) 1370-1373
    CrossrefPubMedGoogle Scholar
  • 25 Chandra SS, Shankar P, Indira R. Depth of penetration of four resin sealers into radicular dentinal tubules: a confocal microscopic study. J Endod 2012; 38 (10) 1412-1416
    CrossrefPubMedGoogle Scholar
  • 26 Tedesco M, Chain MC, Bortoluzzi EA. da Fonseca Roberti Garcia L, Alves AMH, Teixeira CS. Comparison of two observational methods, scanning electron and confocal laser scanning microscopies, in the adhesive interface analysis of endodontic sealers to root dentine. Clin Oral Investig 2018; 22 (06) 2353-2361
    CrossrefPubMedGoogle Scholar
  • 27 Amoroso-Silva PA, Guimarães BM, Marciano MA. et al. Microscopic analysis of the quality of obturation and physical properties of MTA Fillapex. Microsc Res Tech 2014; 77 (12) 1031-1036
    CrossrefPubMedGoogle Scholar
  • 28 Al-Haddad A, Abu Kasim NH, Che Ab Aziz ZA. Interfacial adaptation and thickness of bioceramic-based root canal sealers. Dent Mater J 2015; 34 (04) 516-521
    CrossrefPubMedGoogle Scholar
  • 29 Thota MM, Sudha K, Malini DL, Madhavi SB. Effect of different irrigating solutions on depth of penetration of sealer into dentinal tubules: a confocal microscopic study. Contemp Clin Dent 2017; 8 (03) 391-394
    CrossrefPubMedGoogle Scholar
  • 30 Jeong JW, DeGraft-Johnson A, Dorn SO. Di Fiore PM. Dentinal tubule penetration of a calcium silicate-based root canal sealer with different obturation methods. J Endod 2017; 43 (04) 633-637
    CrossrefPubMedGoogle Scholar
  • 31 El Hachem R, Le Brun G, Le Jeune B, Pellen F, Khalil I, Abboud M. Influence of the EndoActivator irrigation system on dentinal tubule penetration of a novel tricalcium silicate-based sealer. Dent J (Basel 2018; 6 (03) 45
    CrossrefPubMedGoogle Scholar
  • 32 McMichael GE, Primus CM, Opperman LA. Dentinal tubule penetration of tricalcium silicate sealers. J Endod 2016; 42 (04) 632-636
    CrossrefPubMedGoogle Scholar
  • 33 Mjör IA, Smith MR, Ferrari M, Mannocci F. The structure of dentine in the apical region of human teeth. Int Endod J 2001; 34 (05) 346-353
    CrossrefPubMedGoogle Scholar
  • 34 Schilder H. Filling root canals in three dimensions. 1967. J Endod 2006; 32 (04) 281-290
    CrossrefPubMedGoogle Scholar
  • 35 Bowman CJ, Baumgartner JC. Gutta-percha obturation of lateral grooves and depressions. J Endod 2002; 28 (03) 220-223
    CrossrefPubMedGoogle Scholar
  • 36 Qu W, Bai W, Liang YH, Gao XJ. Influence of warm vertical compaction technique on physical properties of root canal sealers. J Endod 2016; 42 (12) 1829-1833
    CrossrefPubMedGoogle Scholar
  • 37 Qu W, Bai W, Liang YH, Gao XJ. [Real temperature of the continuous-wave pluggers]. Beijing Da Xue Xue Bao 2015; 47 (05) 834-837
    PubMedGoogle Scholar
  • 38 Smith RS, Weller RN, Loushine RJ, Kimbrough WF. Effect of varying the depth of heat application on the adaptability of gutta-percha during warm vertical compaction. J Endod 2000; 26 (11) 668-672
    CrossrefPubMedGoogle Scholar
  • 39 Kim S, Kratchman S. Modern endodontic surgery concepts and practice: a review. J Endod 2006; 32 (07) 601-623
    CrossrefPubMedGoogle Scholar
  • 40 Roy A, Astekar M, Bansal R, Gurtu A, Kumar M, Agarwal LK. Racial predilection of C-shaped canal configuration in the mandibular second molar. J Conserv Dent 2019; 22 (02) 133-138
    CrossrefPubMedGoogle Scholar
  • 41 Gok T, Capar ID, Akcay I, Keles A. Evaluation of different techniques for filling simulated C-shaped canals of 3-dimensional printed resin teeth. J Endod 2017; 43 (09) 1559-1564
    CrossrefPubMedGoogle Scholar
  • 42 Kim JA, Hwang YC, Rosa V, Yu MK, Lee KW, Min KS. Root canal filling quality of a premixed calcium silicate endodontic sealer applied using gutta-percha cone-mediated ultrasonic activation. J Endod 2018; 44 (01) 133-138
    CrossrefPubMedGoogle Scholar
  • 43 Hwang JH, Chung J, Na HS, Park E, Kwak S, Kim HC. Comparison of bacterial leakage resistance of various root canal filling materials and methods: confocal laser-scanning microscope study. Scanning 2015; 37 (06) 422-428
    CrossrefPubMedGoogle Scholar
  • 44 El Hachem R, Khalil I, Le Brun G. et al. Dentinal tubule penetration of AH Plus, BC Sealer and a novel tricalcium silicate sealer: a confocal laser scanning microscopy study. Clin Oral Investig 2019; 23 (04) 1871-1876
    CrossrefPubMedGoogle Scholar
  • 45 Uzunoglu-Özyürek E, Erdoğan Ö, Aktemur Türker S. Effect of calcium hydroxide dressing on the dentinal tubule penetration of 2 different root canal sealers: a confocal laser scanning microscopic study. J Endod 2018; 44 (06) 1018-1023
    CrossrefPubMedGoogle Scholar
  • 46 Ko SY, Choi HW, Jeong ED. et al. Main and accessory canal filling quality of a premixed calcium silicate endodontic sealer according to different obturation techniques. Materials (Basel 2020; 13 (19) 4389
    CrossrefPubMedGoogle Scholar
  • 47 De-Deus G, Brandão MC, Leal F. et al. Lack of correlation between sealer penetration into dentinal tubules and sealability in nonbonded root fillings. Int Endod J 2012; 45 (07) 642-651
    CrossrefPubMedGoogle Scholar
  • 48 Machado R, Silva UX Neto, Carneiro E, Fariniuk LF, Westphalen VP, Cunha RS. Lack of correlation between tubular dentine cement penetration, adhesiveness and leakage in roots filled with gutta percha and an endodontic cement based on epoxy amine resin. J Appl Oral Sci 2014; 22 (01) 22-28
    CrossrefPubMedGoogle Scholar