Abstract
Objective The aim of this study was to compare the degree of dentinal penetration between an epoxy resin-based sealer applied by using two different filling methods and an ultrasonically activated calcium silicate-based sealer via confocal laser scanning microscopy (CLSM). Materials and Methods Forty-five extracted permanent maxillary premolars with type II canals (Vertucci’s classification) were subjected to the experiment. The root canals were instrumented and distributed randomly into the following three groups: AH Plus + continuous wave technique (AHC group); AH Plus + single cone technique (AHS group); and Endoseal MTA + single cone technique with ultrasonic activation (EMS) group. Each sealer was labeled with rhodamine B dye to allow visualization under CLSM. The sealer penetration depth in each sample was observed at 2 mm and 5 mm from the apex by using CLSM. The data were statistically analyzed by using analysis of variance or Kruskal–Wallis H test according to normality of variable (α = 0.05). Results In all groups, the maximum sealer penetration depth, mean fluorescence intensity, and sum fluorescence intensity values were higher at the 5-mm level than at the 2-mm level. At the 5-mm level, the EMS group showed the lowest value ( p = 0.02). At the 2-mm level, there were no statistically significant differences among any of the groups. The AHC group showed higher values than the other groups, but there was no statistically significant difference in the apical area where access of instruments was difficult. Conclusion The AHC group showed the highest dentinal tubule penetration, but had questionable filing efficacy in the apical area, which is of particular importance for the success of root canal treatment. Therefore, in areas such as the apical 2 mm of premolars with type II canals, which are difficult to access by using instruments such as heat carriers, other appropriate approaches may be required accordingly.
Highlights
The aim of root canal filling is to prevent reinfection of the shaped and disinfected root canal
Complete canal obturation is important for this purpose, and the sealer plays an important role in minimizing the space between the gutta percha (GP) and the canal wall
The AHC group showed the highest sum fluorescence intensity (SFI) value at all levels and the AHS group showed the lowest value at all levels, but there was no statistically significant difference among all three groups at either level (►Fig. 5, Kruskal–Wallis H test for the 2-mm level and ANOVA for the 5-mm level). ►Table 1 shows the distribution of variables at 2-mm and 5-mm levels in each group
Summary
The aim of root canal filling is to prevent reinfection of the shaped and disinfected root canal. Complete canal obturation is important for this purpose, and the sealer plays an important role in minimizing the space between the gutta percha (GP) and the canal wall. Since root canal sealers play an important role in canal filling, efforts have been made in recent years to develop various sealers along with obturation methods. The continuous wave technique—which is a sort of warm vertical GP technique—is a method of applying pressure after softening the GP by applying a heat source to the master cone and shows good sealing ability.[1] The single cone technique is a method of filling root canal with one gutta-percha cone of the same size and taper as the root canal preparation and a sealer.[2] It is an easy and inexpensive method because there is no need for a separate heat carrier or back filling device
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