Exploring the Most Effective Apical Seal for Contemporary Bioceramic and Conventional Endodontic Sealers Using Three Obturation Techniques

Comparison of Different Obturation Techniques in the Dentinal Tubule Penetration of EndoSequence® Bioceramic Sealer HiFlow™: An In-Vitro Study

Background This study aimed to assess the dentinal tubule penetration of bioceramic sealer (DTPB) using EndoSequence® Bioceramic Sealer HiFlow™ (BCHF). Three obturation techniques were compared, namely, single cone (SC), cold lateral condensation (CLC), and warm vertical compaction (WVC) using scanning electron microscopy (SEM). Methodology A total of 45 intact mandibular premolars were decoronated, instrumented, and irrigated with uniform procedures. Subsequently, they were randomly assigned into the following three groups according to the gutta-percha and BCHF obturation technique: Group 1 (n = 15) with the SC technique, Group 2 (n = 15) with the CLC technique, and Group 3 (n = 15) with the WVC technique. Afterward, the roots were sectioned at three levels (coronal, middle, apical) from the apex and examined using SEM to determine the maximum distance of DTPB in µm. The collected data were analyzed using SPSS software (IBM Corp., Armonk, NY, USA) using the one-way analysis of variance test and Bonferroni tests. The level of significance was set at α of 0.05. Results Significant differences were observed in the maximum distances of DTPB values among the three levels across groups (p < 0.05). Both the WVC and CLC groups exhibited higher values compared to the SC group (p < 0.05). Specifically, the DTPB maximum distance at the apical third was significantly higher in the CLC group than in the WVC and SC groups (p < 0.05). Additionally, the coronal third in each group demonstrated significant DTPB maximum distance (p < 0.05) compared to the other groups. Conclusions BCHF with the WVC and CLC obturation technique showed the best performance in DTPB maximum distance values at the three levels.

Radiographic Assessment of the Quality of Root Canal Filling of Mandibular First Molars Performed by Endodontists in Asir Region, Saudi Arabia

AIM

This study aimed to assess and evaluate the quality of root canal fillings (RCFs) conducted on mandibular first molars performed by endodontists in the Asir region, Saudi Arabia.

PARTICIPANTS AND METHODS

A cross-sectional radiographical study was conducted among patients over 18 years old from both genders treated by endodontists with different qualifications and experiences. The treatments were carried out under similar operating field, materials, and equipment. The quality of the X-rays was evaluated according to the international standards in the form of length, density, and taper. Those radiographs were assessed by two evaluators with similar certificates. Intraexaminer agreements were calculated. Chi-square or Fisher's exact tests were used to test the significant difference between groups and the quality parameters. p < 0.05 was considered a cutoff point for statistical significance.

RESULTS

A total of 74 mandibular molars with 224 root canals treated were assessed in this radiographic study. The recorded adequate percentages were 77, 93, and 91% for the quality of RCF taper, density, and taper, respectively, with acceptable overall RCF quality of 87%. Significant differences were recorded between the right and left sides in terms of taper (p = 0.035), as well as between different years of experiences and different locations of the canals in terms of density (p = 0.040 for both variables).

CONCLUSION

The quality of RCFs performed by endodontist with different type of certificates performed in mandibular first molars were high in terms of density and taper but moderate in length. The overall RCF quality was acceptable.

CLINICAL SIGNIFICANCE

Evaluation of the postoperative preapical X-rays for the endodontically treated teeth is a positive point in maintaining high standard services of patients. It should be followed as mentioned in the recommended textbooks in relation to length, taper, and density. How to cite this article: Almnea RA. Radiographic Assessment of the Quality of Root Canal Filling of Mandibular First Molars Performed by Endodontists in Asir Region, Saudi Arabia. J Contemp Dent Pract 2024;25(7):624-630.

Comparative Evaluation of Push-out Bond Strength of Three Different Root Canal Sealers: An In Vitro Study

AIM

The aim of this present study was to compare the dislodgement resistance of calcium silicate-based sealer, zinc oxide sealer, and a new sealer combining both zinc oxide and calcium silicate-based sealer in vitro.

MATERIALS AND METHODS

60 single-rooted human teeth were instrumented with F3 Protaper Gold. All endodontic canals were filled using gutta percha cones using the cold lateral condensation technique in combination using one of the mentioned sealers (n = 20 per group). The teeth were divided into three groups: group A consisted of Sealite® Ultra, group B consisted of K-Sealer®, and group C consisted of BioRoot® RC. After 2 months of incubation (37°C, 100% humidity) and after cutting out 2 mm from the most apical portion of the root apex, six slices of 1 mm thickness were generated. Mechanical dislodgement resistance was examined using a universal pressure-testing machine and the push-out bond strength (POBS) was calculated. Specimens were examined under 20× magnification to define the bond failure mode. Statistical analysis was executed using ANOVA, post hoc Turkey test for pairwise comparisons and Kruskal-Wallis tests.

RESULTS

The POBS of BioRoot® was significantly higher than the POBS of the two other sealers with a mean of 10.54 MPa ± 2.10 and 5.73 MPa ± 2.34, respectively (p < 0.001). Sealite® and K-Sealer® showed similar results in the median and coronal part. K-Sealer® revealed highest POBS compared with Sealite® in the apical part (p < 0.05).

CONCLUSION

The POBS of the zinc oxide and calcium silicate-based sealer was significantly lower compared with calcium silicate. Sealite® and K-Sealer® exhibited almost same results. BioRoot showed the highest POBS of all sealers.

CLINICAL SIGNIFICANCE

The current study was needed to evaluate the bond strength of three different cements to dentinal walls, by evaluating their respective POBS in vitro. The findings of this study may provide guidance for the clinician in the selection of an adequate endodontic sealer that guarantees an enhanced adhesive seal between the Gutta-percha and the dentinal canal walls. How to cite this article: Makhlouf MP, El Helou JD, Zogheib CE, et al. Comparative Evaluation of Push-out Bond Strength of Three Different Root Canal Sealers: An In Vitro Study. J Contemp Dent Pract 2024;25(1):15-19.