The Penetration Ability of Calcium Silicate Root Canal Sealers into Dentinal Tubules Compared to Conventional Resin-Based Sealer: A Confocal Laser Scanning Microscopy Study

Abstract

The purpose of this study was to compare the penetration ability of calcium silicate root canal sealers and conventional resin-based sealer using confocal laser scanning microscopy (CLSM). A total of 60 recently extracted single-rooted human premolars were used in this study. The root canals were prepared to a size 40/0.06 taper with ProFile rotary instruments and irrigated with NaOCl and EDTA. After drying all canals, the specimens were randomly divided into three experimental groups (n = 20): Group 1, gutta-percha (GP)/AH Plus with continuous wave compaction; group 2, GP/BioRoot RCS with a single-cone technique; and group 3, GP/Endoseal MTA with a single-cone technique. All experimental samples were sectioned perpendicular to their long axis using a low-speed diamond wheel at the apical, middle, and coronal third levels. The penetration abilities of all samples were evaluated using CLSM. A Kruskal–Wallis analysis and a series of Mann–Whitney U post hoc tests were performed. A higher intensity level was found in the coronal area and a lower intensity level in the apical area in all the experimental groups. The AH Plus group showed higher sum fluorescence intensity in the apical and coronal thirds compared with the BioRoot RCS and Endoseal MTA groups, whereas the BioRoot RCS group showed a higher intensity level in the middle third, similar to the AH Plus group. The maximum sealer penetration depth was low in the apical area and high in the coronal area in the AH Plus and Endoseal MTA groups. In the BioRoot RCS group, maximum sealer penetration was observed in the middle third. In conclusion, there were significant differences in sealer penetration pattern and distance according to the root level and sealer type.

Could the Calcium Silicate-Based Sealer Presentation Form Influence Dentinal Sealing? An In Vitro Confocal Laser Study on Tubular Penetration

“…On the other hand, McMichael et al [ 42 ] also found lower percentage values in resin-based materials when compared to silicate-based materials using single-cone technique, but the results for resin-based materials were superior when using continuous wave technique. The results from the study performed by Kim et al [ 18 ] are also consistent with these findings. In the present study, the single-cone technique was used as a standardized obturation technique for all of the sealer samples, aiming to avoid the influence of the differences in obturation technique on the results.…”

“…Dentine tubular penetration represents a physical barrier for microorganisms and increases the retention of the sealer [ 17 , 18 ], hence, the importance of its assessment in these new materials. Among the factors that determine the tubular penetration of root canal sealers, the consistency and fluidity are two relevant parameters to be considered.…”

“…Confocal Laser Scanning Microscopy (CLSM) is a widely used technique for the study of tubular penetration of various materials. Several published studies in the field use this method to evaluate the penetration of sealing cements [ 16 , 17 , 18 , 19 ]. However, there is limited evidence regarding the difference of dentinal tubule penetration between premixed and powder/liquid silicate-based sealers specifically [ 19 ].…”

Calcium silicate-based root canal sealers: a literature review

“…After canal obturation with each sealer, roots are embedded in a self-cure resin and sectioned perpendicular to the long axis of the root. Then, CLSM is used to evaluate the patterns or depth of dentin-penetrating sealer [ 35 ]. In the evaluation of dye leakage, each root is immersed in freshly prepared 1% methylene blue dye for 72 hours after canal obturation.…”

Biocompatibility and Mineralization Activity of Three Calcium Silicate-Based Root Canal Sealers Compared to Conventional Resin-Based Sealer in Human Dental Pulp Stem Cells

“…The most commonly used sealers are calcium hydroxide sealers, glass ionomer sealers, zinc oxide eugenol sealers, resin-based sealers, and the recently introduced calcium silicate-based sealers. AH Plus Plus (Dentsply DeTrey GmbH, Konstanz, Germany) is a conventional epoxy resin-based root canal sealer with low microleakage and good penetration ability into dentinal walls [8,9]. This sealer exhibits toxicity when freshly mixed that gradually reduces upon setting [7,10].…”