Abstract
Sealer staining using rhodamine B dye to investigate the penetration depth of endodontic sealers was proven unsuitable for this purpose. This study aimed to investigate the sealer penetration depth into dentinal tubules by scanning electron microscopy (SEM). Root canals of 52 human upper central incisors were instrumented using the ProTaper Gold NiTi system (Dentsply Sirona, York, PA, USA) up to size F3. After irrigation with sodium hypochlorite and citric acid combined with ultrasonic activation, the root canals were either filled using the epoxy resin sealer AH Plus (Dentsply Sirona) or the calcium silicate-based sealer Total Fill BC Sealer HiFlow (TFHF, FKG Dentaire, La Chaux-de-Fonds, Switzerland) by warm vertical compaction. Root slices of 1 mm thickness were obtained at 2 to 3, 5 to 6 and 8 to 9 mm from the apex. The root slices were investigated for sealer penetration into the dentinal tubules using SEM according to four root quadrants (buccal, mesial, oral, distal). Statistical analysis was performed by the Kruskal-Wallis test (p = 0.05) as data were not normally distributed according to the Shapiro-Wilk test. AH Plus penetrated significantly deeper into the dentinal tubules compared to TFHF at each root level (p < 0.05). Dentinal sealer penetration was deeper in the bucco-oral direction compared to the mesio-distal direction. AH Plus penetrated deeper into dentinal tubules than TFHF. Warm vertical compaction exerting high pressure on the root canal filling material is not able to press sealers deep into dentinal tubules as penetration depth values did not exceed a mean of 110 µm in SEM.
Highlights
Warm vertical obturation of the root canal space was introduced to increase the amount of gutta-percha core material in a root canal filling and to use the pressure applied on the thermo-plasticized material to press endodontic sealer into isthmuses and dentinal tubules [1]
Regarding sealer penetration depth into dentinal tubules, results inconsistent with the above-mentioned theorem have been published in the past
While some studies could not find a relationship between the filling technique and the penetration depth [2,3,4,5], a correlation of the penetration depth with the applied pressure on the root canal filling material was reported in one study [6]
Summary
Warm vertical obturation of the root canal space was introduced to increase the amount of gutta-percha core material in a root canal filling and to use the pressure applied on the thermo-plasticized material to press endodontic sealer into isthmuses and dentinal tubules [1]. No other root canal obturation technique allows such forces to press sealer in the most unreachable parts of the root canal system [1]. Though differences in tubule penetration are reasonable when different techniques are applied, no such effect can be concluded from the available studies. While it was argued that tooth-dependent factors such as variations of the root canal morphology could be the reason for the inconsistency of the studies [2], the results could be interpreted as a lack of validation of the investigation technique [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
