Assessment of the Sealing Ability of Endodontic Sealants by X-ray Microtomography.

Abstract

Introduction: The anatomical complexity of the root canal system poses significant challenges for endodontic treatment, which aims to remove infected pulp tissue and microorganisms, prevent reinfection, and preserve the natural tooth. A critical aspect of successful endodontic treatment is the complete sealing of the root canal space to prevent microleakage and microbial contamination. Different types of sealants with Gutta-Percha are used to achieve this goal, each with unique properties that affect their performance. Traditional sealants, such as those based on epoxy resins, and newer bioceramic sealants offer various benefits and limitations in their sealing capabilities. The hydrophilicity of a sealant, its ability to wet moist dentinal walls, and its behaviour in the moist environment of the root canal are crucial factors influencing its effectiveness. Insights into the performance of these sealants can help in determining the best materials for improving endodontic success rates . Objective: This study aimed to evaluate the sealing efficiency of four different root canal sealants using a single cone obturation technique, with a focus on comparing voids volumes in the root canal space of roots filled with various sealants . Materials and Methods: Forty human maxillary incisor teeth with single straight root canals were used, divided into five groups: Gutta percha only (control), AH plus with GP, BioRoot™ RCS with GP, GuttaFlow Bioseal® with GP, and a novel sealant with GP. The root canals were prepared and obturated following standard protocols. X-ray microtomography (XMT) was utilized to scan the samples pre-obturation and post-obturation, allowing for the measurement of void volumes and comparison between the different sealants. Results: The mean percentage of voids was highest in the GP only (control) group (48.86%) and lowest in the GuttaFlow Bioseal® group (17.36%). Statistically significant differences were found between the GP only group and all other groups, as well as between BioRoot™ RCS and both the novel and GuttaFlow Bioseal® sealants. The apical third of the canals exhibited significantly fewer voids in the novel sealant and GuttaFlow Bioseal® groups compared to AH plus and BioRoot™ RCS groups. Conclusion: The novel and GuttaFlow Bioseal® sealants demonstrated superior sealing abilities with fewer voids compared to AH plus and BioRoot™ RCS sealants. The findings suggest that the premixed and injectable nature of these sealants contribute to their enhanced performance in the moist environment of the root canal, thus improving the success rates of endodontic treatments.