A laboratory assessment of coronal bacterial leakage in root canals filled with new and conventional sealers

Abstract

To evaluate the resistance to ex vivo bacterial leakage over a 40-day period of root canal fillings with five new root canal sealers: RC Sealer, Epiphany, EndoREZ, GuttaFlow and Acroseal, compared with Apexit, AH Plus and RoekoSeal. One hundred and forty-four single rooted human teeth were divided randomly into eight test (n = 15) and two control groups (n = 12). The root canals were filled using a single cone technique with gutta-percha except in the Epiphany and EndoREZ groups. These were filled with Resilon and resin-coated gutta-percha, respectively. The gutta-percha surface of the GuttaFlow group was coated with an experimental primer prior to filling. Positive controls were filled with gutta-percha without sealer and tested with bacteria, whereas negative controls were sealed with wax to test the seal between the chambers. Filled roots were incorporated in a split chamber model system using Streptococcus mutans as a microbial marker. Leakage was assessed for turbidity of the broth in the lower chamber every day for 40 days. Survival analysis was performed using the Kaplan-Meier product limit method and event times were compared using the Log-rank test (alpha = 0.05). Epiphany, GuttaFlow with test primer and Apexit prevented leakage significantly better than AH Plus, RC Sealer, RoekoSeal, EndoREZ and Acroseal (P < 0.05). None of the specimens in the AH Plus, RC Sealer, RoekoSeal and EndoREZ groups resisted bacterial penetration for 40 days. The new sealers, Epiphany and GuttaFlow with primer, along with Apexit, showed better resistance to bacterial penetration than the other new or traditional sealers tested.