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