The Effect of Sealer Application Methods on Voids Volume after Aging of Three Calcium Silicate-Based Sealers: A Micro-Computed Tomography Study

Abstract

During obturation, air voids are undesirable as they may provide shelter for microorganisms or passage for fluids. This study aimed to compare the occurrence of voids between three calcium silicate-based sealers (CSBSs) (MTA-Fillapex, BioRoot-RCS, Bio-C) and the change in their volume after aging. In addition, we aimed to compare voids when using two sealer application methods: lentulo-spiral (LS) and gutta-percha (GP) cone. Thirty extracted mandibular premolars (n = 30) were endodontically prepared and obturated using single GP cone (SGPC) technique. Each sealer was applied to 10 teeth (n = 10) using LS or GP. Micro-computed tomography (micro-CT) was used to quantify the volume of root filling and voids before and after 8-week storage in a phosphate-rich medium. The percentage of root filling and voids were compared between the groups using a Mann–Whitney U test and Kruskal–Wallis test with a Bonferroni correction. Before aging, the percentages of root filling volume after obturation were comparable with no significant differences between sealers (p = 0.325) or application methods (p = 0.950). After aging, the voids’ volume increased significantly in all sealers (p ≤ 0.05). However, no significant differences were found between sealers (p = 0.302). In conclusion, voids in CSBSs may not reduce in size with aging; hence, SGPC should be carefully selected for suitable cases.

Interfacial adaptation of NeoMTA Plus, BioRoot RCS and MTA in root‐end cavities: A micro‐CT study

“…However, in the present study, gap‐free interfacial adaptations were not observed. This data agrees with previous studies that use these same materials for retro‐filling and perforation sealing (Atmeh et al, 2022; Bianco et al, 2020; Jardine et al, 2021). However, the fact that they have good properties (alkalinization, induction of mineralized tissue, and good sealing) to use in cases of perforation or root filling could also be profitable for use in cases of surgical retreatment.…”

A Micro-CT Analysis of Initial and Long-Term Pores Volume and Porosity of Bioactive Endodontic Sealers

“…These results for Total Fill BC Sealer and BioRoot RCS are in agreement with previous studies [ 9 ]. However, a statistically significant increase in total volume of pores after 8 weeks of storage in a phosphate-rich medium for BioRoot RCS was observed by Atmeh et al [ 28 ].…”

“…The presence of pores was most frequently analyzed due to the space in which bacteria can re-grow and proliferate, causing long-term treatment failures [ 9 , 26 , 28 , 31 , 44 , 45 ]. Unfortunately, none of the filling materials or application methods can provide a pore-free root canal filling [ 9 , 45 , 46 ].…”

“…The release of calcium ions over time can contribute to the formation of precipitates that can accumulate in pores, thereby reducing their number over time [ 53 ]. Such a decrease in the number of pores may be associated with improved sealing ability, thus reducing the risk of micro-leakage and its clinical implications, i.e., development or persistence of periapical inflammation leading to treatment failure [ 28 ]. In the present study, after 6 months, the total volume of pores decreased for GuttaFlow Bioseal and Total-Fill BC Sealer, while they increased for BioRoot RCS.…”

“…The re-colonization can occur with bacterial survival (biofilm) originating from coronal regions, inside the canal space, or outside the canal or infected soft tissue [ 27 ]. The single-cone technique is the recommended method of canal filling using both types of sealers [ 21 , 23 , 28 , 29 ]. It requires a GP cone of a size and taper matching the final instruments used for the canal preparation.…”