World Journal of Dentistry

Register      Login

VOLUME 14 , ISSUE 7 ( July, 2023 ) > List of Articles


Irrigation Sequence Influence on Penetration of Root Canal Sealers in Dentinal Tubule: Confocal Laser Scanning Microscopy and Push-out Bond Strength Analysis

Geetanshu Bhalla, Abhishek Bansal, Navneet Kukreja, Ankita Sharma, Swati Chhabra, Surinder Sachdeva

Keywords : AH plus, Confocal laser scanning microscopy, MTA fillapex, Push-out bond strength, Zinc oxide eugenol sealer

Citation Information : Bhalla G, Bansal A, Kukreja N, Sharma A, Chhabra S, Sachdeva S. Irrigation Sequence Influence on Penetration of Root Canal Sealers in Dentinal Tubule: Confocal Laser Scanning Microscopy and Push-out Bond Strength Analysis. World J Dent 2023; 14 (7):598-603.

DOI: 10.5005/jp-journals-10015-2266

License: CC BY-NC 4.0

Published Online: 01-09-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: To assess the influence of irrigation sequence on penetration and push-out bond strength of three root canal sealers into radicular dentin and their chemical interaction by confocal laser scanning microscopy (CLSM). Materials and methods: A total of 90 caries-free single-rooted mandibular premolars were decoronated up to cementoenamel junction (CEJ) and for biomechanical preparation, WaveOne Gold primary files were used. Based on the irrigation sequence used, samples were divided into group I (30)—5% sodium hypochlorite (NaOCl) + 17% ethylenediaminetetraacetic acid (EDTA) + distilled water, group II (30)—17% EDTA + 5% NaOCl + distilled water, and group III (30)—5% NaOCl + distilled water. These groups were further subdivided into subgroups based on the sealers used for obturation [AH plus, zinc oxide (ZnO) eugenol, mineral trioxide aggregate (MTA) fillapex, respectively] and mixed with 0.1% rhodamine B dye for fluorescence. Samples were viewed under the Confocal laser scanning microscope, and 2 mm thick slices from coronal, middle, and apical sections were analyzed for push-out bond strength using the universal testing machine. One-way analysis of variance (ANOVA) and Tukey's post hoc analysis were done (p-value < 0.05). Results: The results obtained were statistically significant (p-value < 0.05), with the greatest push-out bond strength with group I, followed by group II, and the least with group III. With respect to the sealer used for obturation, AH plus exhibited better penetration, followed by MTA fillapex, and the least penetration was seen in the case of the ZnO eugenol sealer. Apical sections exhibited greater bond strength, while maximum sealer penetration was seen in the coronal sections. Conclusion: The sequence in which the irrigation protocol is followed does affect the dentinal tubule penetration of root canal sealers and their bonding with dentin. The final irrigation sequence of 5% NaOCl and 17% EDTA proved to be more effective for sealer penetration into the dentinal tubules. Clinical significance: The irrigation regime followed is important in achieving disinfection as well as smear layer removal. This directly influences the sealer penetration percentage and has a positive effect on sealer penetration depth.

  1. Ingle JI, Beveridge EE, Glick DH, et al. Endodontic success & failure: the Washington Study. Chapter 1: Modern Endodontic Therapy. In: Ingle JL, Bakland LK, editors. Endodontics. 4th ed. Williams & Wilkins; Baltimore, MD:1994. pp. 21–45.
  2. Kara Tuncer A, Tuncer S. Effect of different final irrigation solutions on dentinal tubule penetration depth and percentage of root canal sealer. J Endod 2012;38(6):860–863. DOI: 10.1016/j.joen.2012.03.008
  3. Byström A, Sundqvist G. Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy. Scand J Dent Res 1981;89(4):321–328. DOI: 10.1111/j.1600-0722.1981.tb01689.x
  4. Peters OA. Current challenges and concepts in the preparation of root canal systems: a review. J Endod 2004;30(8):559–567. DOI: 10.1097/01.don.0000129039.59003.9d
  5. Violich DR, Chandler NP. The smear layer in endodontics: a review. Int Endod J 2010;43(1):2–15. DOI: 10.1111/j.1365-2591.2009.01627.x
  6. Wu MK, Fan B, Wesselink PR. Diminished leakage along root canals filled with gutta-percha without sealer over time: a laboratory study. Int Endod J 2000;33(2):121–125. DOI: 10.1046/j.1365-2591.2000.00274.x
  7. Al-Haddad A, Che Ab Aziz ZA. Bioceramic-based root canal sealers: a review. Int J Biomater 2016;2016:9753210. DOI: 10.1155/2016/9753210
  8. Trivedi S, Chhabra S, Bansal A, et al. Evaluation of sealing ability of three root canal sealers: an in vitro study. J Contemp Dent Pract 2020;21(3):291–295. DOI: 10.5005/jp-journals-10024-2768
  9. Ungor M, Onay EO, Orucoglu H. Push-out bond strengths: the Epiphany-Resilion endodontic obturation system compared with different pairings of Epiphany, Resilion, AH Plus and gutta-percha. Int Endod J 2006;39(8):643–647. DOI: 10.1111/j.1365-2591.2006.01132.x
  10. Musale PK, Mujawar SA. Evaluation of the efficacy of rotary vs. hand files in root canal preparation of primary teeth in vitro using CBCT. Eur Arch Paediatr Dent 2014;15(2):113–120. DOI: 10.1007/s40368-013-0072-1
  11. Paqué F, Ganahl D, Peters OA. Effects of root canal preparation on apical geometry assessed by micro-computed tomography. J Endod 2009;35(7):1056–1059. DOI: 10.1016/j.joen.2009.04.020
  12. Peters OA, Scheönenberger K, Laib A. Effects of four Ni–Ti preparation techniques on root canal geometry assessed by micro computed tomography. Int Endod J 2001;34(3):221–230. DOI: 10.1046/j.1365-2591.2001.00373.x
  13. Uppalapati LV, Mandava J. Evaluation of push-out bond strengths of two different adhesive root canal obturation systems. J NTR Univ Health Sci 2012;1(2):111. DOI: 10.4103/2277-8632.98356
  14. Balguerie E, Georgelin-Gurgel M, Diemer F, et al. Root canal sealers: scanning electron microscope study of tubular penetration. European Cells and Materials 2007;13(1):29.
  15. Baldissera R, Rosa RAD, Santini M, et al. CLSM assessment of tubule penetration and bacterial leakage evaluation of two resin-based sealer. J Res Dent 2014;2(5):388–397. DOI: 10.19177/jrd.v2e52014388-397
  16. Pawar AM, Pawar S, Kfir A, et al. Push-out bond strength of root fillings made with C-Point and BC sealer versus gutta-percha and AH Plus after the instrumentation of oval canals with the Self-Adjusting File versus WaveOne. Int Endod J 2015;49(4):374–381. DOI: 10.1111/iej.12455
  17. Branstetter J, von Fraunhofer JA. The physical properties and sealing action of endodontic sealer cements: a review of the literature. J Endod 1982;8(7): 312–316. DOI: 10.1016/S0099-2399(82)80280-X
  18. Shakya VK, Gupta P, Tikku AP, et al. An invitro evaluation of antimicrobial efficacy and flow characteristics for AH Plus, MTA Fillapex, CRCS and Gutta Flow 2 root canal sealer. J Clin Diagn Res 2016;10(8):ZC104–ZC108. DOI: 10.7860/JCDR/2016/20885.8351
  19. Lee KW, Williams MC, Camps JJ, et al. Adhesion of endodontic sealers to dentin and gutta-percha. J Endod 2002;28(10):684–688. DOI: 10.1097/00004770-200210000-00002
  20. Fisher MA, Berzins DW, Bahcall JK. An in vitro comparison of bond strength of various obturation materials to root canal dentin using a push-out test design. J Endod 2007;33(7):856–888. DOI: 10.1016/j.joen.2007.02.011
  21. Yavari H, Shahi S, Galledar S, et al. Effect of retreatment on the push-out bond strength of MTA-based and epoxy resin-based endodontic sealers. J Dent Res Dent Clin Dent Prospects 2017;11(1):43–47. DOI: 10.15171/joddd.2017.008
  22. Mohammadi Z, Shalavi S, Jafarzadeh H. Ethylenediaminetetraacetic acid in endodontics. Eur J Dent 2013;7(Suppl 1):S135–S142. DOI: 10.4103/1305-7456.119091
  23. Sagsen B, Ustün Y, Demirbuga S, et al. Push-out bond strength of two new calcium silicate-based endodontic sealers to root canal dentine. Int Endod J 2011;44(12):1088–1091. DOI: 10.1111/j.1365-2591.2011.01925.x
  24. Hamid HA, Al-Azzawi AKJ. The effect of smear layer on push-out bond strength to dentin of Bioceramic sealer (in vitro study). J Bagh Coll Dent 2013;25(4):5–11. DOI: 10.12816/0015057
  25. De-Deus GA, Accorsi-Mendonça T, de Carvalho e Silva L, et al. Self-adjusting file cleaning-shaping-irrigation system improves root-filling bond strength. J Endod 2013;39(2):254–257. DOI: 10.1016/j.joen.2012.10.026
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.