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

Paula Muedra,Julia Guerrero-Gironés,José L Sanz,Francesco Riccitiello,Leopoldo Forner,Adrián Lozano,Carmen Llena,Francisco J Rodríguez-Lozano,Gianrico Spagnuolo

doi:10.3390/ma14030659

Abstract

Dentinal tubule penetration influences root canal treatment sealing. The aim of this study was to compare dentinal penetration of two clinical presentations of silicate-based sealers using confocal laser. Sixty single-rooted human teeth from 50–70 year-old patients extracted for orthodontic/periodontal reasons were used. Canals were prepared using Mtwo system up to 35/0.04, with 5.25% NaOCl irrigation and final irrigation using 17% EDTA. Teeth were randomly assigned into study groups (ni = 20): EndoSequence BC sealer (ES, group 1), BioRoot RCS (BR, group 2); and a control group (nc = 20) with AH Plus (AHP). Root canals were obturated with 35/0.04 gutta-percha (single-cone technique). The samples were obtained from apical, middle, and coronal thirds. Dentinal tubule penetration depth and percentage of penetration around the canal perimeter were measured. The statistical analysis was performed using Mann Whitney U test and Wilcoxon t-test (95% confidence interval). ES exhibited a significantly higher penetration than AHP in apical and middle thirds (p < 0.05), and in middle and coronal thirds relative to BR (p < 0.05). The percentage of penetration around the canal perimeter was significantly higher for ES compared to BR in all thirds, but only in the apical third for AHP (p < 0.05). The pre-mixed silicate-based sealer exhibited better penetration than the powder/liquid one.

Highlights

The objective of root canal obturation is to hermetically seal the canal system so that it is isolated, and prevent any leakage into or out of the root
Biocompatibility acts as a desirable biological property of endodontic sealers since, during root canal treatment, part of the biomaterial may inadvertently extrude from the root canal towards the surrounding tissues
To the authors’ knowledge, the novelty of this paper resides in the fact that this is the first study to explore the differences in dentinal tubule penetration between silicate-based endodontic sealers in terms of their form of presentation

Summary

Introduction

The objective of root canal obturation is to hermetically seal the canal system so that it is isolated, and prevent any leakage into or out of the root. Resin-based sealers have been the most widely used due to their low solubility, apical sealing ability, and handling [1]. Their biocompatibility with periapical tissues is still a subject of study. Biocompatibility acts as a desirable biological property of endodontic sealers since, during root canal treatment, part of the biomaterial may inadvertently extrude from the root canal towards the surrounding tissues. This may result in an inflammatory response from such tissues, which may hinder the healing of any pre-existing lesions [3,4]

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Conclusion