Main and Accessory Canal Filling Quality of a Premixed Calcium Silicate Endodontic Sealer According to Different Obturation Techniques

Abstract

The present study aimed to investigate the effects of different obturation techniques on the main and accessory canal filling quality of a premixed calcium silicate endodontic sealer (Endoseal TCS). We also highlighted the validity of the methods used for evaluating the canal filling quality. Thirty single-rooted premolars were used for the main canal filling and 75 were used for accessory canal filling. The canals were instrumented and randomly divided into three groups according to the filling techniques: (1) single-cone technique (SC), (2) single-cone with ultrasonic activation (SU), and (3) warm vertical compaction (WV). Voids in relation to the root canal fillings were assessed using cross-section images from microcomputed tomography (μCT) scans or transversely sectioned tooth specimens (n = 10). After demineralization and clearing of the teeth, the incidence, number, and completeness of the accessory canal fillings were evaluated (n = 25). One-way analysis of variance (ANOVA) and Tukey’s post hoc test was used for the evaluation of the voids in the main root canal and the incidence and number of filled accessory canals. Pearson’s chi-squared (χ2) test was used for the evaluation of the filling completeness (α = 0.05). In the stereomicroscopic evaluation of the sectioned specimen, the SC group had significantly higher void occurrence than the other groups (p < 0.05), although there was no difference between groups in the μCT evaluation. However, there was no difference between the SU and WV. There was no difference between all the groups regarding the incidence, number, and completeness of the accessory canal fillings. When the premixed calcium silicate sealer is used with SC, the ultrasonic activation is recommended to obtain a better main canal filling quality. In contrast, the obturation techniques did not affect the accessory canal filling. We also recommend using the sectioning method when the void formation in the root canal filling materials is evaluated.

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

“…In some recent papers, Endoseal was reported that it showed the best filling ability without voids among the sealers used when the Endoseal was injected into the canal with a syringe and activated ultrasonically set on power "8." 46 However, the EMS group showed markedly lower maximum sealer penetration depth values, whereas this was not the case for MFI and SFI values. The maximum sealer penetration depth value refers directly to the maximum degree to which the sealer can penetrate.…”

Comparison of Root Filling Quality of Two Types of Single Cone-Based Canal Filling Methods in Complex Root Canal Anatomies: The Ultrasonic Vibration and Thermo-Hydrodynamic Obturation versus Single-Cone Technique

“…This presents a dilemma for clinicians, since it is impracticable to precisely evaluate the complexity of root canal systems and the completeness of the root fillings clinically (Figure 3). However, only a few studies have investigated the root filling quality using the SC technique in complex root canal systems [10,11,17,18,21]. Considering these consequential issues, the present study was confined to human teeth with two root canals with complex anatomies, and the outcome of the noncompaction SC canal filling group with calcium silicate-based root canal sealer was quite divergent from that reported in previous SC filling studies using the same materials [8,10,11].…”

“…This concept has become increasingly popular, owing to its simplicity and short procedural time [8]. Recently, the SC technique has been gaining popularity among clinicians, accompanied by an increase in the use of calcium silicate-based root canal sealers [8][9][10][11]. Endoseal TCS (Maruchi, Wonju, Korea) is one of the latest, premixed, ready-to-use calcium silicate paste endodontic sealers, which is supplied in syringes.…”

Ultrasonic vibration and thermo‐hydrodynamic technique for filling root canals: Technical overview and a case series

“…Even with their bioactive properties, insufficient filling would lead to insufficient sealing. To compensate for the drawbacks of insufficient sealer dispersion, sealer coated gutta‐percha master cone can be applied with a pumping motion in the canal, or sealer can be injected deeply and directly into the apical portion of root canals (Kim et al, 2017; Ko et al, 2020). However, these methods could lead to the unwanted apical extrusion of sealer (Kim et al, 2017), which is uncontrollable and can be dangerous clinically (Alves et al, 2020).…”