Endodontic Teaching Research Articles

Endodontic Continuing Education of Dental Practitioners in Croatia: A Nationwide Survey

AIM: This study aims to assess the state of endodontic continuing education (ECE) among dental practitioners in Croatia and identify factors influencing participation in such education. METHODS: A questionnaire was sent to all dental offices in Croatia, yielding 819 responses. The data were analyzed descriptively and statistically modeled. RESULTS: Most respondents had participated in some form of ECE during their careers. However, in the past 5 years, only about 78% had engaged in such education, with participation decreasing by 2% for each additional year of practice. Male practitioners had significantly less continuing education in the past 5 years, particularly in private clinics, dental clinics with concession contracts, and certain regions. Practitioners who performed more endodontic treatments reported higher levels of continuing education. The endometer was the only modern technique consistently used by about 60% of practitioners with continuing dental education. CONCLUSION: Continuing education in endodontics should be more strongly promoted among practitioners with longer careers, particularly men.

Evaluating the effectiveness of a novel training model in dental preclinical regenerative endodontic education.

Regenerative endodontic procedures (REPs) are tissue engineering-based treatments aimed at regenerating the pulp-dentin complex. However, these procedures are not widely practiced or well-known among dentists due to a lack of training. This study aims to develop a practical hands-on training model for REPs to enhance students' theoretical knowledge and practical skills. A cost-effective, easy-to-operate, and reusable training model for preclinical training of REPs was developed. A total of 125 undergraduates were divided into an experimental group (REPs model) and a control group (traditional teaching). The students' theoretical knowledge and operational skills were assessed through examinations and practical assessments. Student perceptions were assessed by questionnaires. The experimental group achieved higher scores in theoretical knowledge and operational skills compared to the control group (p < .001). The process evaluation of the experimental group demonstrated a high level of proficiency in executing root canal disinfection steps, with pass rates ranging from 93.5% to 95.2%. Students in both groups perceived the model as valuable for improving critical thinking, stimulating interest, and enhancing their confidence and proficiency. The developed REPs training model is a practical and effective tool for teaching and training regenerative endodontics. It bridges the gap between preclinical and clinical education, enhancing students' confidence and clinical competence.

A multi-national survey-based evaluation of undergraduate/predoctoral endodontic education.

To evaluate the current status of endodontic education and assessment at an undergraduate/predoctoral level in dental schools worldwide. The current survey comprised a 50-item online questionnaire related to undergraduate endodontic education. The project leaders emailed the survey's details to faculty members responsible for endodontic teaching at one dental school in every country to seek their willingness to participate in the survey. After the faculty members accepted, the survey details were sent to participants along with the survey link. Simple descriptive statistics were used to represent the data. Amongst the 44 faculty members from different countries who agreed to participate, 36 completed the survey. Endodontic training starts in 50% of dental schools from the third year of the curriculum. Each dental school employs a diverse range of educational methods. During pre-clinical training, 19.4% of the participating dental schools used only natural teeth. Stainless-steel hand instruments, syringe irrigation with a needle, resin-based sealer and the cold lateral compaction technique are the most frequently used in pre-clinical and clinical training. A significant percentage of dental institutions necessitate that students treat a predetermined quantity of canals or teeth throughout their pre-clinical and clinical education. Dental institutions conduct formative, summative or a combination of the formative and summative throughout the clinical and pre-clinical phases of endodontic training. According to the data collected from this survey, there are considerable variations in the curriculum for undergraduate/predoctoral endodontic programmes amongst the surveyed dental schools. Pre-clinical and clinical education should integrate a larger array of modern tools and procedures.

Undergraduate endodontic curricula across Canadian Dental Schools: A cross-sectional analysis.

This study aimed to evaluate and assess the degree of uniformity in endodontics education at the undergraduate level among Canadian dental schools. The objective is to enhance Canadian dental education programs to meet societal oral health needs while incorporating advancements in the field of endodontics. An online survey comprising 36 multiple-choice questions targeting the nature of endodontic teaching was conducted as our methodology. Participation was sought from directors of the undergraduate endodontics program at all ten Canadian dental schools in 2021 and 2022. A remarkable 100% response rate and the findings revealed a certain level of consistency among Canadian schools concerning pedagogical and assessment methods, as well as the endodontic topics taught to undergraduate students. However, notable variations were observed in the equipment and materials utilized. This study serves as a fundamental reference for identifying future modifications to the undergraduate endodontics curriculum in Canada.

Evaluation of Knowledge, Attitude, and Practice (KAP) of Artificial Intelligence in Endodontics and Implantology Education: A Cross-sectional Study

Purpose: The purposes of this study were to assess the knowledge, attitude, and practice (KAP) of AI in Endodontics and implantology education among dental professionals' and dental students in Endodontics and implantology education at the Kingdom of Saudi Arabia. Materials and methods: The present study is a descriptive cross-sectional online survey that was carried out among dental students and dental professionals in the Kingdom of Saudi Arabia. A self-structured, close-ended questionnaire that was administered that consisted of 17 questions was included. The questionnaire validity and reliability were evaluated for vetting and remarks. The questions were circulated through Google Forms, and it was circulated among the study participants through online mode. The data were collected systematically, and SPSS Statistics version 26.0 was used for data analysis. Results: There were 805 responses, (443 dental students and 362 dental professionals') participated in the study through Google Forms. Among these, 435 (54%) were females and 370 (46%) were males. In the study group, 491 (61.0%) were aware of AI, and 314 (39.0 %) were not aware (p-value 0.000). Among the 17 questions used to assess the KAP, 12 questions were significant with a p-value less than 0.05. More than 73 % prefer to use artificial intelligence in endodontics and implantology education. About 120 (14.9%) agreed that AI will replace the role of dentists in the future. There were no significant results in comparing dental students and dental professionals. Conclusion: The current study contributes valuable insights into knowledge, attitudes, and perceptions related to artificial intelligence among dental student and professionals in the Kingdom of Saudi Arabia. Despite some reservations, the majority show a positive view towards the role of AI in the endodontic education, which indicates fertile ground for further exploration and integration of AI technologies into endodontic education. There is a need for continued future research to explore strategies to improve the potential of AI while test their reliability and relevance in endodontic and implantology education.

A survey on the application of online and offline blended teaching in microendodontics

Objective: To evaluate the effect of online and offline blended teaching in microendodontics, attempting to promote the widespread application of blended teaching mode in Operative Dentistry and Endodontics. Methods: A questionnaire survey was carried out among 865 trainees who attended the blended teaching in microendodontics combined the online theory curriculum and offline practice training from April 6 to 28 in 2022, organized by Department of Operative Dentistry and Endodontics, Hospital of Stomatotogy, Sun Yat-sen University. The content of questionnaire included trainees' basic information as well as their perspectives and expectations on the teaching mode. Data was analyzed by SPSS 24.0 and Chi-square test was used for enumeration data. Results: A total of 855 trainees participated in the valid survey with the effective recall rate of 98.8% (855/865), 50.3% (430/855) of which were young people in 18-30 years old. Their working period ranged from 0.5 to 40 years. Physicians and physician assistants occupied 40.9% (350/855) and 32.9% (281/855), respectively. And the intermediate and senior titles accounted for 26.2% (224/855). The proportion of trainees who had used and never used dental operative microscope (DOM) were 70.5% (603/855) and 29.5% (252/855), respectively. The blended teaching in microendodontics was universally approved by the trainees, which showed more superiority in the improvement of learning efficiency and interest, comprehension of knowledge as well as practical ability, etc., compared to the traditional offline teaching. For the current stomatology education, trainees were inclined to choose the blended teaching mode combining online theory curriculum and offline practice training, whereas 41.3% (353/855) and 39.6% (339/855) of trainees agreed that the teaching effectiveness was likely influenced by the condition and frequency of the offline training, respectively. Besides, significant differences were detected in the question about the factors affecting the blended teaching effectiveness of microendodontics between the trainees who had used and not used DOM (χ²=13.37, P=0.004). Conclusions: The application of online and offline blended teaching in microendodontics was affirmed to have some advantages, and it should be considered that the discrepancy in the level of expertise among trainees probably influenced the teaching effectiveness, which may promote the quality and effect of teaching, the spread and sharing of microendodontics, and provide experience and reference for the practice teaching of Operative Dentistry and Endodontics.

Mastery Learning in Preclinical Endodontics Using Customized 3D-Printed Tooth Models for Deliberate Practice: An Application of Educational Design Research

IntroductionThis study, conducted within an educational design research (EDR) framework, assessed the use of customized 3D-printed tooth models at various difficulty levels to enhance mastery learning and deliberate practice in preclinical endodontic training. MethodsThe EDR was conducted in a preclinical endodontic training involving 42 third-year students. The study focused on developing and evaluating 3D-printed tooth models customized into 3 difficulty levels to facilitate mastery learning for the access opening procedure on upper anterior teeth. To promote deliberate practice, we ensured ample availability of these models. The evaluation combined quantitative analysis, using Friedman and Wilcoxon Signed-Rank tests to assess practice volume and performance, with qualitative feedback from interviews and focus groups, analyzed via content analysis. ResultsThere was a significant reduction in practice time across the different model levels, with students using an average of 1.5–1.8 models per level. No significant differences in performance scores were observed across levels and natural tooth (P = .333). Feedback highlighted the models' educational value in enhancing dental training, indicating their effectiveness in improving learning experiences and skill development in endodontic education. ConclusionsThe innovative design of a 3D-printed tooth model system, which features 3 levels of difficulty and was developed within an EDR framework, allowed for tailored learning progressions and ample practice opportunities. This significantly enhanced the endodontic training experience and skill development by providing varied and realistic challenges.

EUROPEAN SOCIETY OF ENDODONTOLOGY Undergraduate Curriculum Guidelines for Endodontology.

Undergraduate education should accomplish graduates who are skilled to provide quality care for patients, who are aware of their scope of practice, competency level and limits and who are open to referring patients whose needs are beyond their own skills and experience. They should also become self-efficacious. Quality performance begins with good diagnosis and decision-making. Graduates should understand when to treat, why to treat, what to treat and how to treat. These guidelines include a list of capabilities that the graduating student will be expected to have achieved to provide a minimum level of competency in endodontics. Theoretical knowledge, practical skills, understanding and insight should be assessed, with both formative and summative assessment procedures, making use of reflection and feedback. Endodontic procedures should be undertaken within the context of comprehensive patient care and should be evidence based. Students should not perform treatments on patients until they have demonstrated in a pre-clinical setting that they possess the required skills. Only if it is not possible to simulate a specific procedure sufficiently in a pre-clinical setting should students learn this procedure by performing it clinically under close supervision. Clinical endodontics should ideally be supervised by endodontists or by staff with special knowledge, interest and self-efficacy in endodontics. It is advised to ensure that students apply their knowledge and practice their skills periodically throughout the continuum of endodontic education until graduation. A philosophy of lifelong learning and evidence-based practice should be instilled in all dental undergraduates.

The dental microscope in endodontic education: A feasibility study of a distance learning course.

This study aimed to evaluate the feasibility of preclinical training, specifically in root canal preparation, using a virtual educational system equipped with an operating microscope. Ten postgraduate general dentistry trainees and practitioners undergoing postgraduate training in endodontics participated. The telesimulation course included three steps: theory, demonstration of practical work by the teacher and lastly practical training by the participants. The digital environment including the dental microscope was presented, and the feedback was collected with a questionnaire. The majority of participants considered that the online video conference format allowed them to acquire theoretical content but also practical knowledge and skills, owing to the contribution of the operating microscope. The technical feasibility of endodontic telesimulation was demonstrated. The operating microscope has a potential role in distance education, enabling teaching to occur synchronously and collaboratively. This allows learners to interact with each other and demonstrators in real time.

Students' Perception of Remote Extended Reality Simulation Systems Using Patient-specific Three-Dimensional-printed Models in Endodontic Education: A Pilot Study.

Extended reality (XR) technology using head-mounted devices enables the operator to visu-alise anatomical structures. We aimed to investigate student perceptions regarding applying XR simu-lation for transferring endodontic educational information between a lecturer in Japan and students in Saudi Arabia. In this study, the students engaged with an XR simulation system and viewed teeth in virtual reality (VR). Pictures of dental anatomy were shown in the VR space, allowing participants to manipulate them. Then, the participants viewed a patient-specific three-dimensional printed model and three-dimensional root canal access guide in a second VR area. Before the sessions, the students completed a questionnaire on demograph-ic data and information concerning their VR experience. After the sessions, they completed a questionnaire evaluating the XR simulation system. The questionnaire included questions on dental anatomy, root canal access, usability, emotional impression, and data transfer. Eleven 5th-year dental students, comprising six male and five female students, were enrolled; three of them had previous VR experience, whereas eight did not. The highest levels of satisfaction were noted in the tooth anatomy (4.6+-0.4) and emotional impression (4.5+-0.5) domains, whereas the lowest level was noted in the data transmission domain (3.5+-0.9). Female participants and those without previous VR experience reported higher satisfaction levels across questionnaire domains compared to male participants and those with previous VR experience. XR can be successfully used in dental education and integrated into online lectures. Restrictions on education caused by health crises can be averted by using XR. Further, fifth-generation networks can offer better data transmission than wireless fidelity.

Evaluation of the quality of endodontic access cavities made by students of the institute of dentistry and stomatology of Dakar

The aim of this study was to evaluate the technical quality of endodontic access cavities performed by M1 and M2 students during the clinical teaching of endodontics. The study population consisted of patients who came for consultation in the clinic of the Conservative Odontology-Endodontics Department of the Institute of Odontology and Stomatology of Dakar. The inclusion criteria were for teeth for which endodontic treatment was indicated and an access cavity was performed for the first time and exclusively by a student as part of the clinical training in endodontics. A survey form was drawn up containing the following headings: contour shape, visibility of canal entrances, body shape, and accidents along the way (stop, perforations, or flattening of the pulp floor). The chi-squared test was used to compare quantitative and qualitative variables and the significance level was set at p&amp;#60;0.05.A total of 139 endodontic access cavities were made by students (56.8% by Master 2 (M2) students and 43.2% by Master 1 (M1) students). Of these, 35% of the access cavities made by M1 students were acceptable versus 44% acceptable for M2. The difference was statistically significant (p&amp;#60;0.05).It appears from this study that the rate of technically acceptable access cavities made by the students of the Institute of Odonto-Stomatology of Dakar was insufficient. Thus, modifications must be made in the preclinical and clinical training program of Endodontics students.

Three-Dimensional Printed Tooth Model with Root Canal Ledge: A Novel Educational Tool for Endodontic Training.

Ledge formation presents a significant challenge in endodontic treatment. Yet, there is still a lack of educational tooth models for hands-on practice. This study aimed to create and evaluate a tooth model for ledge management practice. A natural tooth with curved roots was collected for scientific use under ethics committee approval. Following initial root canal preparation, the tooth was scanned using micro-computed tomography (μCT) and 3D reconstructed. A K-file, created via computer-aided design (CAD), was partly inserted into the root canal wall of the 3D reconstructed tooth. By subtracting the K-file from the tooth, a tooth model with a root canal ledge was produced. The model was then 3D printed for a hands-on workshop. An eight-item Likert-scale questionnaire was administered to 20 postgraduate students and 10 endodontists to assess the model's quality and training effectiveness. In addition, the success rate of bypassing and correcting the root canal ledge was documented. The feedback from both the students and experts was positive, and the results of the Mann-Whitney U test indicated no statistically significant differences found between the two groups (p > 0.05). The success rate of the students and the experts was 85% and 100%, respectively. In future applications, this novel tooth model is expected to address the existing gap in endodontic education and provide benefits for dental practitioners.

A bibliometric comparison of undergraduate and postgraduate endodontic education publications: The topics, trends, and challenges.

This study employs bibliometric analysis to compare knowledge units and main topics in undergraduate and postgraduate endodontic education, aiming to identify similarities, differences, and connections. The insights gained are expected to inform the future of two-stage education to enhance continuity, highlighting evolving trends, challenges, and development directions. Citation data were retrieved from the Web of Science Core Collections (WOSCC) database and non-WOSCC databases with two separate search formulas. VOSviewer and CiteSpace were used to analyze the distribution of research by publication years, citation-sources, co-authorship network of authors and countries, and clusters of keywords. The focus on undergraduate education preceded postgraduate education by nearly a decade. The United Kingdom has emerged as the most prominent contributor to endodontic literature at both levels, with the International Endodontic Journal representing the most voluminous and cited resource in this domain. Dummer is recognized as the most prolific author in undergraduate endodontic education, while Gulabivala spearheads the most extensive cluster of postgraduate education. Keywords clustering analysis reveals that undergraduate education places greater emphasis on fundamental knowledge, while postgraduate education concentrates more on clinical practice. Descriptive analyses from non-WOSCC databases align with the topics and findings from WOSCC-based bibliometric analysis. This bibliometric analysis revealed the emphasis on fundamental knowledge and teaching techniques at the undergraduate level versus advanced clinical knowledge and techniques at the postgraduate level, which originated from different learning aims and contexts. Updating the curriculum to meet the latest practices and innovations is crucial for aligning learning objectives with current and future needs, and the connection between the two levels remains a central challenge in endodontic education.

Parallel endodontic education via social media: An exploratory survey study.

There is insufficient research to evaluate social media's influence on endodontic education. Therefore, this study assessed the percentage of students utilising Facebook in their education and the factors influencing their engagement. A survey was conducted on dental students, interns and dentists undertaking specialist programmes. Categorical data were analysed using Fisher's Exact test and multiple pairwise comparisons. The significance level was set at p < 0.05. Responses were received from 801 participants, with 98.4% using Facebook for endodontic knowledge. Although most students knew that scientific evidence is not always provided, they still deemed such information valuable as it was a practical demonstration of clinical cases. Most students turn to Facebook for endodontic education to compensate for the gap between their academic education and clinical practice. The utilisation of social media for education can be a concerning phenomenon and should not be ignored by academic institutes.

Prevalence of Teaching Apical Patency and Various Instrumentation and Obturation Techniques in United States Dental Schools: Two Decades Later

IntroductionMaintaining apical patency has been advocated to minimize canal transportation, ledge formation, and loss of working length, despite increasing debris extrusion. A previous study in 1997 by Cailleteau and Mullaney reported 50% of United States dental schools taught patency. This present study aimed to evaluate recent trends in endodontic education in United States dental schools, in relation to the prevalence of maintaining apical patency and examining the primary methods of working length determination, instrumentation, obturation, and temporization. MethodsA survey of 20 questions was distributed to 65 schools via e-mail and was available from July 2021 to September 2021. ResultsSeventy-three percent of the 46 responding schools reported that they teach patency, with 8% of this number reporting that they do so exclusively to endodontic residents. Notably, a significantly lower number of schools reported teaching patency exclusively to endodontic students compared with the Cailleteau and Mullaney study despite a significantly higher percentage of schools teaching patency overall. The most common method used to determine working length was an electronic apex locator at the 0.5 reading. Vortex Blue was the most commonly used file system used by both predoctoral and postdoctoral programs. Lateral condensation was the primary obturation technique taught in predoctoral programs, whereas warm vertical condensation was the primary obturation technique in postdoctoral programs. The study also found that 57% of schools reported using intraorifice barriers, and the most common temporary filling was glass ionomer. ConclusionsA greater portion of schools teaches patency compared with the previous study in 1997. The data collected in this survey may serve as a baseline for similar studies in the future regarding changes in endodontic education over time.

A comparative study of students’ performance in flipped classroom and structured interactive session teaching learning method in Conservative Dentistry and Endodontics

Introduction: Flipped classroom is an element of blended learning, integrating both face-to-face learning in the class through group discussion and distance learning outside the class by watching video lessons and online collaboration. The objective of the study was to introduce and assess the effectiveness of flipped classroom in teaching and learning of Conservative Dentistry and Endodontics and to understand the perspective of students about the same. Methods: Third year undergraduate dental students were randomly divided into two groups: structured interactive session group and flipped classroom group. Structured interactive session group had their class taken in the traditional manner while the flipped classroom group was given power point presentation and videos beforehand so that students came to class being prepared. The in class time was utilized for group discussions and peer exercises. Same set of questions including multiple choice questions (MCQs) and problem based questions (PBQs) validated by the faculties involved in the research was used for assessment. A questionnaire was then provided to students regarding their perception of flipped classroom method. Results: Among the 41 students, 19 students were in structured interactive session group and 22 were in flipped classroom group. The mean MCQ and PBQ score in structured interactive session group was 69.47 and 59.39 respectively whereas it was 73.17 and 66.55 respectively in flipped classroom group. Conclusions: The performance of flipped classroom group was better in both MCQs and PBQs. Students preferred flipped classroom method and were ready to accept it as their teaching learning modality.

Students' experience and perceptions of undergraduate endodontic education in New Zealand.

This study investigated the clinical experience and perceptions of New Zealand graduating dental students (2019 and 2020) towards endodontic teaching and their clinical learning outcomes using an online survey and clinical scenarios. Quantitative data were analysed using SPSS software, and qualitative data were analysed thematically. Responses were similar for both cohorts (response rates 74%, 2019; 73%, 2020). Endodontic teaching was valuable and interesting but difficult compared with other disciplines. Molar endodontics, finding canals and managing posture were challenging. Students felt more confident and less anxious when supervised by clinicians experienced in endodontics. Time management was the most anxiety-inducing factor and significantly related to clinical experience (p < 0.001). Overall, students appropriately applied knowledge in most areas of endodontics while holistic problem-solving in complex scenarios was variable. Maximising clinical experience and supervision from teachers experienced in endodontics are important for learning, improving confidence and reducing anxiety.

Student\'s confidence level in performing root canal treatment and its correlation with encountered errors

This study aims to investigate the confidence level of undergraduate final-year dental students in performing root canal treatment (RCT) and the relationship to the problems encountered during RCT. A validated online questionnaire was distributed to final-year dental students at Universiti Teknologi MARA. The questionnaire utilized both scaled responses and closed-ended questions to gain data regarding students’ confidence levels in performing root canal treatment. : In this study, 93.4% of the students were confident in placing a rubber dam, 90.8% were confident in injecting local anesthesia and root canal irrigation. Procedures that were rated as least confident were access cavities and management of interappointment flare-ups. For the mean rate of self-confidence in performing RCT in the dentition, maxillary anterior teeth (4.24±0.63) ranked highest followed by mandibular premolars (4.11±0.72), whereas the least confidence was in treating maxillary molars (3.38±0.69). Higher scores of self-confidence were in the management of necrotic pulp (4.22±0.65), followed by vital pulp treatments (3.95±0.61). The main mishaps that students encountered were canal blockage (57.9%) and underestimation of length (52.6%). There is no statistically significant correlation between the confidence level and encountered errors. . : The mean overall confidence score of different endodontic procedures was high, which is 80%. Examining the confidence level of students is a crucial part of this study, which can help to enhance the quality of endodontic education in areas that need improvement.

Study on the Application of the Combination of Students' Micro-video Recording and Reversal Classroom in the Teaching of Endodontics

Dental endodontics teaching requires a high level of combination of theory and practice, and the traditional teaching model alone cannot achieve the goal of enhancing students' autonomous learning ability and clinical practice ability. Conforming to the background of the rapid development of the Internet, this study selected two classes of 2018 5-year stomatology from North China University of Science and Technology as the research objects, and used the combination of student micro-video recording and reversal classrooms to explore the dental body that conforms to the OBE concept. A new model of endodontics teaching, it is expected to provide new ideas for the relevant course professors who need to combine theory with practice.

Assessment of isthmus filling using two obturation techniques performed by students with different levels of clinical experience

Background/purposeRoot canal filling is a necessary skill for dental students and an important aspect of endodontic education. This study aimed to evaluate the effect of students’ clinical experiences on isthmus filling using different techniques and sealers. Materials and methodsOne hundred eight three-dimensional-printed resin replicas of isthmus were divided into six groups and either continuous wave of condensation (CWC) or single-cone obturation (SC) was performed. One of three sealers (AH Plus Jet®, GuttaFlow2, iRoot SP) was used together with a size-fitted gutta-percha master cone. All the obturations were completed by students with three different levels of clinical experience including senior postgraduate students (SPS), junior postgraduate students (JPS), and undergraduate students (US). The percentages of filled areas (PFA) at 2, 4, 6, and 8 mm from the apex were analyzed using a light microscope. Data were analyzed using the Mann-Whitney U test or Kruskal-Wallis 1-way ANOVA with Dunn's tests (α = 0.05). ResultsThe CWC group exhibited a higher PFA than the SC group (P < 0.05). The PFA was higher in the SPS group than in the JPS group or the US group with CWC (P < 0.05). The three clinical experience groups showed similar PFAs with SC (P > 0.05); however, when using SC with iRoot SP, the PFA was higher than with either of the other two sealers (P < 0.05). ConclusionCWC was found to be technique-sensitive and required clinical training. With SC, clinical experience did not improve the quality of isthmus filling without additional training. CWC was superior to SC for type IV isthmuses. When using SC, better filling quality was obtained with a bioceramic sealer.