The effect of irrigating solutions on the apical sealing ability of MTA Fillapex and Adseal root canal sealers

Abstract

Background. Maximum sealing ability or adhesion of endodontic sealers can be achieved after effective removal of the smear layer. Endodontic irrigants assist in adequate removal of the smear layer, improving the retention mechanism. The aim of this study was to evaluate the effect of two different root canal irrigation solutions (5.25% NaOCl followed by 17% EDTA and QMix) on the apical sealing ability of two different root canal sealers (MTA Fillapex and Adseal).Methods. Forty-six single-canal teeth were divided into 4 experimental groups of 10 teeth each and a positive and negative group of 3 teeth each. The root canals were prepared using step-back technique. The teeth in groups 1 and 2 were irrigated with 5.25% NaOCl followed by 17% EDTA and the teeth in groups 3 and 4 were irrigated with QMix. Finally all the teeth were flushed with sterile saline and dried using paper points. Obturation was accomplished by gutta-percha using lateral condensation technique. MTA Fillapex sealer was used in groups 1 and 3 whereas Adseal was used in groups 2 and 4. Dye penetration method was used to evaluate apical leakage. Data were analyzed with Kruskal-Wallis and Mann-Whitney U tests using SPSS 14. Statistical significance was set at P < 0.05.Results. Group 3 showed maximum amount of apical leakage (3.7±0.3 mm) whereas group 2 exhibited the least amount of apical leakage (2.1 ± 0.4 mm) among all the experimental groups. Significant differences were found in the amount of apical leakage between all the groups (P = 0.00001).Conclusion. Within the limitations of this study, 5.25% sodium hypochlorite followed by 17% EDTA and Adseal resulted in the best apical seal.

Influence of the Chelating Solutions in the Resistance of Glass Fiber Posts to the Root Dentin

“…Erosion, caused by irrigating solutions, has been widely evaluated in the literature with the use of SEM that allows a morphologic detailed evaluation of the prepared surface. 21 According to the literature, [20][21][22] depending on the depth, this erosion can be a contributing factor to the vertical root fracture but may contribute to the increasing rates of wallcleaning of the canal, removing debris and bacteria from the root canal. 22,23 This study used a mechanical agitation by ultrasound due to its acoustic transmission and formation of bubbles due to the phenomenon of cavitation, which explodes and increases the temperature and pressure, resulting in waves of impact against the wall of the canal by removing debris.…”

“…21 According to the literature, [20][21][22] depending on the depth, this erosion can be a contributing factor to the vertical root fracture but may contribute to the increasing rates of wallcleaning of the canal, removing debris and bacteria from the root canal. 22,23 This study used a mechanical agitation by ultrasound due to its acoustic transmission and formation of bubbles due to the phenomenon of cavitation, which explodes and increases the temperature and pressure, resulting in waves of impact against the wall of the canal by removing debris. [22][23][24] The debris removal process is aided by the continuous flow of the irrigating solution, promoting increased cleaning.…”

“…22,23 This study used a mechanical agitation by ultrasound due to its acoustic transmission and formation of bubbles due to the phenomenon of cavitation, which explodes and increases the temperature and pressure, resulting in waves of impact against the wall of the canal by removing debris. [22][23][24] The debris removal process is aided by the continuous flow of the irrigating solution, promoting increased cleaning. 25 A recent study showed that the dentin collagen could be affected by some endodontic solutions and that has the potential to influence the efficiency of adhesion of adhesive systems.…”

“…12,18 Some authors claim that the NaOCl may also lead to a shorter union resistance values when used adhesive systems, while those who used the NaOCl with EDTA association, verified best results, 17,29 and also may increase the union resistance of self-conditioning adhesive systems. 22,23 Studies report that the combination of NaOCl and EDTA results in a pH that favors the selective capability of the chelating agent to calcium ions, boosting their action. 13,25,26 In addition, EDTA can selectively remove the hydroxyapatite and noncollagen proteins, avoiding drastic changes of the collagen fibers, 25 which can conserve the intrafibrillar minerals, promoting stability and increasing the resistance to dehydration, favoring the adhesion.…”

Improved sealing ability promoted by calcium silicate-based root canal sealers

“…Endosequence BC Sealer presented a superior sealing ability than AH Plus in a dye penetration evaluation 14 , consisting with the present results. In contrast, MTA Fillapex has demonstrated controversial sealing performance in endodontic literature 13,[15][16][17][18] , what may result from its physicochemical properties 19 and differences in experimental designs such as the evaluation technique.…”