A comparative study of dentinal tubule penetration and the retreatability of EndoSequence BC Sealer HiFlow, iRoot SP, and AH Plus with different obturation techniques

Abstract

Objectives This study aimed to evaluate dentinal tubule penetration and the retreatability of EndoSequence BC Sealer HiFlow (HiFlow), iRoot SP, and AH Plus when using the single-cone (SC) or continuous wave condensation (CWC) technique. Materials and methods Sixty-five single-rooted teeth were instrumented and randomly divided into 5 groups: group 1, AH Plus/CWC; group 2, iRoot SP/CWC; group 3, iRoot SP/SC; group 4, HiFlow/CWC; and group 5, HiFlow/SC. The ability to re-establish patency during endodontic retreatment was recorded, as was the time taken to reach the working length. Dentinal tubule penetration and remaining debris after retreatment were evaluated by confocal microscopy and scanning electron microscopy. Data were analyzed by Kruskal-Wallis test and Dunn’s multiple comparisons test (α = 0.05). Results The HiFlow/CWC and iRoot SP/CWC groups required more time to reach the working length than groups that underwent the SC technique regardless of the sealer used (P < .05). The HiFlow/CWC group showed a significantly higher percentage of sealer penetration area than that of the iRoot SP/SC at 4 mm from the apex (P < .05) and penetrated deeper into dentinal tubules than iRoot SP/SC at both 8-mm and 12-mm levels (P < .05). Moreover, the HiFlow/CWC and HiFlow/SC groups demonstrated less remaining sealer along the canal wall than AH Plus/CWC group at 4-mm level (P < .05). Conclusions HiFlow/CWC technique showed better performance in dentinal tubule penetration than that of iRoot SP/SC. Both HiFlow and iRoot SP combined with CWC technique groups required more retreatment time than the other groups. Furthermore, using HiFlow with either the CWC or SC technique left less remaining sealer at 4-mm level than using AH Plus with the CWC technique during retreatment. Clinical relevance With favorable performance in dentinal tubule penetration and retreatability in endodontic retreatment, the combined use of EndoSequence BC Sealer HiFlow with the recommended continuous wave condensation technique may be a worthwhile choice in root canal treatment.

Biocompatibility of a New Calcium Silicate-Based Root Canal Sealer Mediated via the Modulation of Macrophage Polarization in a Rat Model

“…The manufacturer claims that HiFlow exhibits better flowability and lower viscosity when heated to 150–220 °C and that it is more radiopaque, making it an optimal choice for the warm vertical obturation technique. Our previous study demonstrated that HiFlow combined with the CWC technique resulted in a significantly higher percentage of sealer penetration area than iRoot SP combined with the SC technique at a distance of 4 mm from the apex, and HiFlow combined with the CWC technique penetrated deeper into dentinal tubules than iRoot SP combined with the SC technique at both the 8 mm and 12 mm levels [ 10 ]. Moreover, another study reported that the percentage of void volumes and root canal gaps in the HiFlow/CWC group was lower than that in the HiFlow/SC group.…”

Intratubular penetration capacity of HiFlow bioceramic sealer used with warm obturation techniques and single cone: A confocal laser scanning microscopic study

“…We used one group of SC with BG points as the manufacturers recommended this type of BG points and bioceramic sealer with the SC technique [ 6 , 47 ]. They suggest that the sealing ability should be improved by joining the sealer and gutta-percha with the same bioceramic particles [ 48 ].…”

“…Yang et al. [ 47 ] evaluated two techniques, SC and CW with two bioceramic sealers (HiFlow, iRoot SP®) and one resin sealer (AH Plus®). In the dentinal tubule penetration area HiFlow/CW was significantly higher than in the iRoot SP/SC at apical level.…”

“…In the dentinal tubule penetration area HiFlow/CW was significantly higher than in the iRoot SP/SC at apical level. They also exhibited the HiFlow/CW may have better sealing ability than the iRoot SP/SC technique in the apical third [ 47 ]. HiFlow with the CW had superior sealer penetration in the different thirds of the root canal than iRoot SP® with the SC.…”

Effect of a heat‐based root canal obturation technique on push‐out bond strength of the classical bioceramic and new HiFlow sealer

“…The epoxy resin-based sealer, AH Plus, was used to compare the push-out bond strength to the BC sealers because it is commonly used clinically as well as in other studies (7,10,11). The reason the bond strength of the AH Plus group being lower than the other groups, which corresponds with another study (10), could be because heat application accelerates the chemical reaction of the epoxy resin-based sealer (12).…”