Scanning electron microscopy assessment of tubular penetration depth of root canal sealers combined with different obturation techniques

Milica  Cvjetićanin; Bojana Ramić; Karolina Vukoje; Milan  Drobac; Igor Stojanac; Ljubomir Petrović

doi:10.2298/VSP221017028C

Milica Cvjetićanin University of Novi Sad, Faculty of Medicine, Department of Dental Medicine, Novi Sad, Serbia; Clinic of Dentistry of Vojvodina, Department of Restorative Dentistry and Endodontics, Novi Sad, Serbia
Bojana Ramić University of Novi Sad, Faculty of Medicine, Department of Dental Medicine, Novi Sad, Serbia; Clinic of Dentistry of Vojvodina, Department of Restorative Dentistry and Endodontics, Novi Sad, Serbia
Karolina Vukoje University of Novi Sad, Faculty of Medicine, Department of Dental Medicine, Novi Sad, Serbia; Clinic of Dentistry of Vojvodina, Department of Restorative Dentistry and Endodontics, Novi Sad, Serbia
Milan Drobac University of Novi Sad, Faculty of Medicine, Department of Dental Medicine, Novi Sad, Serbia; Clinic of Dentistry of Vojvodina, Department of Restorative Dentistry and Endodontics, Novi Sad, Serbia
Igor Stojanac University of Novi Sad, Faculty of Medicine, Department of Dental Medicine, Novi Sad, Serbia; Clinic of Dentistry of Vojvodina, Department of Restorative Dentistry and Endodontics, Novi Sad, Serbia
Ljubomir Petrović University of Novi Sad, Faculty of Medicine, Department of Dental Medicine, Novi Sad, Serbia; Clinic of Dentistry of Vojvodina, Department of Restorative Dentistry and Endodontics, Novi Sad, Serbia

DOI: https://doi.org/10.2298/VSP221017028C

Keywords: microscopy, electron, scanning, root canal filling materials, root canal obturation

Abstract

Background/Aim. The ability to effectively and consistently penetrate dentinal tubules is considered a favorable factor for the evaluation of root canal sealers (RCSs). The aim of the study was to assess the penetration depth into dentinal tubules of three RCSs combined with four obturation techniques. Methods. The mesial canals of 66 extracted human mandibular molars were endodontically prepared and randomly allocated into 12 experimental groups depending on the RCS type used (AH Plus^™, EndoREZ^™, Sealapex^™) as well as the obturation technique applied [cold lateral compaction, cone-fit, carrier-based (with heated gutta-percha), warm vertical compaction]. Using scanning electron microscopy, transversal root cross-sections were analyzed, and the maximum depth of RCS penetration was measured (396 sections, in total, corresponded to the apical, middle, and coronary third). Results. Group AH Plus^™/warm vertical compaction yielded the highest penetration depth – 1,165 μm, followed by EndoREZ^™/cone-fit – 1,154 μm; the lowest depth was measured for EndoREZ^™/warm vertical compaction – 502 μm. The mean value of the maximum penetration depth of RCS yielded 1,204 μm in the coronary thirds, 1,005 μm in the middle thirds, and 770 μm in the apical thirds. The AH Plus^™ RCS penetrated deeper into dentinal tubules when the obturation techniques with heated gutta-percha were applied, while the opposite findings were obtained for the EndoREZ^™RCS. Conclusion. According to our research, the RCS penetration depth appears to be influenced by the RCS type used, as well as the obturation technique applied.

References

Mamootil K, Messer HH. Penetration of dentinal tubules by en-dodontic sealer cements in extracted teeth and in vivo. Int Endod J 2007; 40(11): 873–81.

Viapiana R, Guerreiro-Tanomaru J, Tanomaru-Filho M, Camilleri J. Interface of dentine to root canal sealers. J Dent 2014; 42(3): 336–50.

Heran J, Khalid S, Albaaj F, Tomson PL, Camilleri J. The single cone obturation technique with a modified warm filler. J Dent 2019; 89: 103181.

Long J, Kreft JU, Camilleri J. Antimicrobial and ultrastructural properties of root canal filling materials exposed to bacterial challenge. J Dent 2020; 93: 103283.

Balguerie E, van der Sluis L, Vallaeys K, Gurgel-Georgelin M, Diemer F. Sealer penetration and adaptation in the dentinal tubules: a scanning electron microscopic study. J Endod 2011; 37(11): 1576–9.

Collares FM, Leitune VCB, Portella FF, Santos PD, Balbinot GS, Dos Santos LA, et al. Methacrylate-based root canal sealer con-taining chlorexidine and α-tricalcium phosphate. J Biomed Mater Res B Appl Biomater 2018; 106(4): 1439–43.

Turkyilmaz A, Erdemir A. Comparison of dentin penetration ability of different root canal sealers used with different obtu-ration methods. Microsc Res Tech 2020; 83(12): 1544–51.

McMichael GE, Primus CM, Opperman LA. Dentinal Tubule Penetration of Tricalcium Silicate Sealers. J Endod 2016; 42(4): 632–6.

Kuçi A, Alaçam T, Yavaş O, Ergul-Ulger Z, Kayaoglu G. Sealer penetration into dentinal tubules in the presence or absence of smear layer: a confocal laser scanning microscopic study. J En-dod 2014; 40(10): 1627–31.

Cvjeticanin M, Zorica D, Krstonošić V, Hadnađev M, Stojanac I, Ramic B, et al. The Influence of Temperature on Rheological Properties of Three Root Canal Sealers. Mater Plastice 2022; 59(2): 174–82.

Schmidt S, Schäfer E, Bürklein S, Rohrbach A, Donnermeyer D. Minimal Dentinal Tubule Penetration of Endodontic Sealers in Warm Vertical Compaction by Direct Detection via SEM Analysis. J Clin Med 2021; 10(19): 4440.

Küçük M, Kermeoğlu F. Efficacy of different irrigation methods on dentinal tubule penetration of Chlorhexidine, QMix and Irritrol: A confocal laser scanning microscopy study. Aust En-dod J 2019; 45(2): 202–8.

Reynolds JZ, Augsburger RA, Svoboda KKH, Jalali P. Comparing dentinal tubule penetration of conventional and “HiFlow” bi-oceramic sealers with resin-based sealer: An in vitro study. Aust Endod J 2020; 46(3): 387–93.

Ramić BD, Stojanac IL, Drobac MR, Kantardžić IR, Maletin AZ, Cvjetićanin MT, et al. Application of Scanning Electron Mi-croscopy in the observation of dentin-adhesive interface. Mi-crosc Res Tech 2021; 84(4): 602–7.

Donnermeyer D, Schmidt S, Rohrbach A, Berlandi J, Bürklein S, Schäfer E. Debunking the Concept of Dentinal Tubule Pene-tration of Endodontic Sealers: Sealer Staining with Rhoda-mine B Fluorescent Dye Is an Inadequate Method. Materials (Basel) 2021; 14(12): 3211.

Caceres C, Larrain MR, Monsalve M, Peña Bengoa F. Dentinal Tubule Penetration and Adaptation of Bio-C Sealer and AH-Plus: A Comparative SEM Evaluation. Eur Endod J 2021; 6(2): 216–20.

Allan NA, Walton RC, Schaeffer MA. Setting times for endo-dontic sealers under clinical usage and in vitro conditions. J Endod 2001; 27(6): 421–3. Erratum in: J Endod 2001; 27(10): 626.

AlEisa K, Al-Dwairi ZN, Lynch E, Lynch CD. In vitro evalua-tion of the effect of different endodontic sealers on retentive strength of fiber posts. Oper Dent 2013; 38(5): 539–44.

Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol 1984; 58(5): 589–99.

Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol 1971; 32(2): 271–5.

Donnermeyer D, Schäfer E, Bürklein S. Real-time Intracanal Temperature Measurement During Different Obturation Techniques. J Endod 2018; 44(12): 1832–6.

Ordinola-Zapata R, Bramante CM, Bernardineli N, Graeff MS, Garcia RB, de Moraes IG, et al. A preliminary study of the per-centage of sealer penetration in roots obturated with the Thermafil and RealSeal-1 obturation techniques in mesial root canals of mandibular molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108(6): 961–8.

Moon YM, Shon WJ, Baek SH, Bae KS, Kum KY, Lee W. Effect of final irrigation regimen on sealer penetration in curved root canals. J Endod 2010; 36(4): 732–6.

American Association of Endodontists. Endodontics: Colleagues for Excellence. Obturation of root canal systems [Internet]. 2009 [accessed on 2023 July 13]. Available from: https://beste

ndoglenview.com/wp-content/uploads/2022/07/Obturation-of-root-canal-systems.pdf

Viapiana R, Guerreiro-Tanomaru JM, Tanomaru-Filho M, Camil-leri J. Investigation of the effect of sealer use on the heat gen-erated at the external root surface during root canal obtura-tion using warm vertical compaction technique with System B heat source. J Endod 2014; 40(4): 555–61.

Camilleri J. Sealers and warm gutta-percha obturation tech-niques. J Endod 2015; 41(1): 72–8.

Chavarria-Bolanos D, Komabayashi T, Shen I, Vega-Baudrit J, Gandolfi MG, Prati C, et al. Effects of heat on seven endodon-tic sealers. J Oral Sci 2022; 64(1): 33–9.

Rai RU, Singbal KP, Parekh V. The effect of temperature on rheological properties of endodontic sealers. J Conserv Dent 2016; 19(2): 116–9.

Baldi JV, Bernardes RA, Duarte MA, Ordinola-Zapata R, Caven-ago BC, Moraes JC, et al. Variability of physicochemical prop-erties of an epoxy resin sealer taken from different parts of the same tube. Int Endod J 2012; 45(10): 915–20.

Moradi S, Ghoddusi J, Forghani M. Evaluation of dentinal tu-bule penetration after the use of dentin bonding agent as a root canal sealer. J Endod 2009; 35(11): 1563–6.

Furtado TC, de Bem IA, Machado LS, Pereira JR, Só MVR, da Rosa RA. Intratubular penetration of endodontic sealers de-pends on the fluorophore used for CLSM assessment. Microsc Res Tech 2021; 84(2): 305–12.