Comparison of three different sealer placement techniques: An In vitro confocal laser microscopic study

Abstract

Introduction:Three-dimensional obturation of the root canal system is the final objective of root canal therapy. Greater penetration of sealer in root dentine lesser will be the voids at the dentine–sealer interface. Hence, analysis of the dentin/sealer interface allows the determination of a filling technique which could obturate the root canals with least gaps and voids. Therefore, the aim of this study is to compare the depth and percentage of sealer penetration into root dentin using three different root canal sealer placement techniques under confocal laser scanning microscope.Materials and Methods:Thirty single-rooted teeth were selected and prepared. Adseal sealer (Meta Biomed, South Korea) was mixed with Rhodamine B dye and applied using lentulo spiral (Dentsply Maillefer, USA) as Group 1, bidirectional spiral (EZ-Fill– EDS, USA) as Group 2, and ultrasonic endodontic tip (Sonofile– Dentsply Tulsa, USA) as Group 3. Canals were then obturated with gutta-percha. The roots were sectioned at the 3 and 6-mm levels from the apical foramen and examined under confocal laser microscope.Results:Maximum mean depth and percentage of sealer penetration were observed for Group 1 and minimum for Group 3. Furthermore, statistical significant differences among Group 1 and Group 3 were found at 6-mm level and among Group 2 and Group 3 were found at 3-mm level (P < 0.05).Conclusion:The depth and percentage of sealer penetration of sealer are influenced by the type of placement technique and by the root canal level, with penetration decreasing apically. Lentulo spiral has shown better penetration of sealer than the bidirectional file and ultrasonics.

Confocal Laser Scanning Microscopy Evaluation of the Effect of Lentulo Spiral and Ultrasonic Activation on Intra-tubular Sealer Penetration

“…These effects frequently occur in the irrigants during passive ultrasonic irrigation. On the other hand, these findings are in disagreement with Dash et al 27 who used ultrasonic tip at lower power than that in the current study.…”

“…This may be attributed to the more efficient rotary motion of the lentulo spiral in a relatively wider cervical region where the smear layer is more effectively removed. Dash et al 27 reported that Lentulo spiral technique had a mean penetration depth and percentage higher than the ultrasonic technique because the lentulo spiral forces the sealer along the instrument length, whereas ultrasonic files move the sealer centrifugally.The intratubular sealer penetration findings showed that the activated Irrisafe ultrasonic tip performed better than lentulo spiral in the apical region in agreement with previous studies. 24,28 These findings might result from the transmission of acoustic microstreaming energy generated by the ultrasonic tip, which probably forced the sealer into these areas.…”

Influence of chelating solutions on tubular dentin sealer penetration: A systematic review with network meta‐analysis

“…However, it is not possible to affirm that the differences in maximum depth values in the present review are related to these factors given that other factors, such as the use of a lentulo spiral, may interfere with the process. Lentulo has an action that pushes the sealer centrifugally (43), which could result in better sealer penetration compared with a master cone.…”

Effect of peracetic acid used as single irrigant on the smear layer, adhesion, and penetrability of AH Plus

“…37 Confocal laser scanning microscope (CLSM) has been employed for evaluating the sealer penetration. [38][39][40] CLSM has several advantages, such as being able to use non-decalcified or hard tissue samples that do not require a specific sectioning technique (sputter coating), providing detailed information about the presence and distribution of sealers at relatively low magnification through the use of fluorescent rhodamine-marked sealers, and allowing the exclusion of artifacts from the sample. 38 In the present study, sealer penetration into root dentin was influenced by the irrigant used.…”