Comparing Sectional and Total Dentin Bond Strengths of Three Endodontic Sealers after Using the Single-cone Obturation Technique: An In Vitro Study
Mohamed El Sayed
Keywords :
AH Plus sealer, Dentin bond strength, GuttaFlow 2 sealer, RealSeal SE, Root canal obturation, Single cone obturation technique
Citation Information :
El Sayed M. Comparing Sectional and Total Dentin Bond Strengths of Three Endodontic Sealers after Using the Single-cone Obturation Technique: An In Vitro Study. J Contemp Dent Pract 2024; 25 (10):976-982.
Aim: This study aimed to investigate and compare the total and sectional bond strengths of three endodontic sealers when used with the single-cone obturation technique.
Materials and methods: Forty-five human maxillary central incisors were prepared and divided into three groups according to the type of endodontic sealer: Group I (Gutta-percha/AH Plus Jet), group II (Gutta-percha/GuttaFlow 2), and group III (RealSeal/RealSeal SE). All canals were filled with the single-cone technique. Roots were sectioned and scanning electron microscope (SEM) analysis was performed on randomly selected samples from each group to assess the root canal filling interfaces. A root section from each root level was subjected to a push-out test. The sectional and total bond strengths were analyzed, then the failure modes were investigated. Statistical analysis was performed using one-way analysis of variance (ANOVA) and Tukey's test, and alpha was set at 0.05.
Results: Significant differences in bond strength values were observed (p < 0.05), with RealSeal SE demonstrating the highest bond strength, particularly in the middle and apical root regions. On the contrary, GuttaFlow 2 exhibited the lowest bond strength. Cohesive failure modes were more common for AH Plus Jet and GuttaFlow 2, while RealSeal SE showed cohesive and adhesive failures. The SEM analysis revealed that each sealer exhibited different levels of adaptability to dentin and core material.
Conclusion: RealSeal SE and AH Plus Jet showed superior bond strength compared to GuttaFlow 2 when the single-cone obturation technique was used. The apical root sections exhibited the highest bond strength for all sealers, except for AH Plus Jet, which showed a higher bond strength in the coronal root sections.
Clinical significance: The current findings could guide dental professionals in choosing the most appropriate sealer for the single-cone obturation technique, potentially leading to more effective obturation procedures, especially for teeth requiring post and core restoration.
Kandemir Demirci G, Çalışkan MK. A prospective randomized comparative study of cold lateral condensation versus Core/Gutta-percha in teeth with periapical lesions. J Endod 2016;42(2):206–210. DOI: 10.1016/j.joen.2015.10.022.
Florez Ariza JE, Aristizabal Elejalde D, Rodrigez Cardenas YA, et al. Adaptation of a single-cone in prepared teeth with two reciprocating systems. Iran Endod J 2022;17(1):27–34. DOI: 10.22037/iej.v17i1.26419.
Komabayashi T, Colmenar D, Cvach N, et al. Comprehensive review of current endodontic sealers. Dent Mater J 2020;39(5):703–720. DOI: 10.4012/dmj.2019-288.
Stelzer R, Schaller HG, Gernhardt CR. Push-out bond strength of RealSeal SE and AH Plus after using different irrigation solutions. J Endod 2014;40(10):1654–1657. DOI: 10.1016/j.joen.2014.05.001.
Carvalho NK, Prado MC, Senna PM, et al. Do smear-layer removal agents affect the push-out bond strength of calcium silicate-based endodontic sealers? Int Endod J 2017;50(6):612–619. DOI: 10.1111/iej.12662.
Kim YK, Mai S, Haycock JR, et al. The self-etching potential of RealSeal versus RealSeal SE. J Endod 2009;35(9):1264–1269. DOI: 10.1016/j.joen.2009.05.008.
Mai S, Kim YK, Hiraishi N, et al. Evaluation of the true self-etching potential of a fourth generation self-adhesive methacrylate resin-based sealer. J Endod 2009;35(6):870–874. DOI: 10.1016/j.joen.2009.01.025.
Vasiliadis L, Kodonas K, Economides N, et al. Short- and long-term sealing ability of Gutta-flow and AH-Plus using an ex vivo fluid transport model. Int Endod J 2010;43(5):377–381. DOI: 10.1111/j.1365-2591.2010.01689.x.
Rana M, Sandhu GK, Kaur T, et al. New self curing root canal filling material: Gutta flow 2. J Adv Med Dent Sci Res 2014;2(4):15–20. Available from: https://jamdsr.com/uploadfiles/3.NewSelfCuringRootCanalFillingMaterialGuttaflow2.20141212071224.pdf
Dem K, Wu Y, Kaminga AC, et al. The push out bond strength of polydimethylsiloxane endodontic sealers to dentin. BMC Oral Health 2019;19(1):181. DOI: 10.1186/s12903-019-0867-5.
Chen WP, Chen YY, Huang SH, et al. Limitations of push-out test in bond strength measurement. J Endod 2013;39(2):283–287. DOI: 10.1016/j.joen.2012.11.002.
Kinney JH, Balooch M, Marshall GW, et al. A micromechanics model of the elastic properties of human dentine. Arch Oral Biol 1999;44(10):813–822. DOI: 10.1016/s0003-9969(99)00080-1.
Williams C, Loushine RJ, Weller RN, et al. A comparison of cohesive strength and stiffness of Resilon and gutta-percha. J Endod 2006;32(6):553–555. DOI: 10.1016/j.joen.2005.08.002.
Costa JA, Rached-Júnior FA, Souza-Gabriel AE, et al. Push-out strength of methacrylate resin-based sealers to root canal walls. Int Endod J 2010;43(8):698–706. DOI: 10.1111/j.1365-2591.2010.01766.x.
Nagas E, Uyanik O, Durmaz V, et al. Effect of plunger diameter on the push-out bond values of different root filling materials. Int Endod J 2011;44(10):950–955. DOI: 10.1111/j.1365-2591.2011.01913.x.
Anantula K, Ganta AK. Evaluation and comparison of sealing ability of three different obturation techniques-lateral condensation, Obtura II, and GuttaFlow: An in vitro study. J Conserv Dent 201;14(1):57–61. DOI: 10.4103/0972-0707.80748.
Nakashima K, Terata R. Effect of pH modified EDTA solution to the properties of dentin. J Endod 2005;31(1):47–49. Erratum in: J Endod 2005;31(6):477. DOI: 10.1097/01.don.0000134205.05404.8e.
Bhandi SH, Subash TS. Comparative evaluation of sealing ability of three newer root canal obturating materials guttaflow, resilon and thermafil: An in vitro study. J Int Oral Health 2013;5(1):54–65. PMID: 24155579.
Carneiro SM, Sousa-Neto MD, Rached FA Jr, et al. Push-out strength of root fillings with or without thermomechanical compaction. Int Endod J 2012;45(9):821–828. DOI: 10.1111/j.1365-2591.2012.02039.x.
Pawińska M, Kierklo A, Tokajuk G, et al. New endodontic obturation systems and their interfacial bond strength with intraradicular dentine-ex vivo studies. Adv Med SCTi 2011;56(2):327–333. DOI: 10.2478/v10039-011-0031-1.
Skidmore LJ, Berzins DW, Bahcall JK. An in vitro comparison of the intraradicular dentin bond strength of resilon and gutta-percha. J Endod 2006;32(10):963–966. DOI: 10.1016/j.joen.2006.03.020.
Chandarani S, Gundappa M, Chowdhary Z, et al. Comparative evaluation of push-out bond strength of AH-Plus, MTA-Fillapex and Epiphany SE root canal sealers: An ex-vivo study. Indian J Dent Res 2022;33(3):313–317. DOI: 10.4103/ijdr.ijdr_1052_21.
Mjör IA, Smith MR, Ferrari M, et al. The structure of dentine in the apical region of human teeth. Int Endod J 2001;34(5):346–353. DOI: 10.1046/j.1365-2591.2001.00393.x.
Ha WN, Nicholson TM, Kahler B, et al. Rheological characterization as an alternative method to indentation for determining the setting time of restorative and endodontic cements. Materials (Basel) 2017;10(12):1451. DOI: 10.3390/ma10121451.
Bouillaguet S, Shaw L, Barthelemy J, et al. Long-term sealing ability of pulp canal sealer, AH-Plus, GuttaFlow and Epiphany. Int Endod J 2008;41(3):219–226. DOI: 10.1111/j.1365-2591.2007.01343.x.
Adhikari HD, Jain S. Scanning electron microscopic evaluation of marginal adaptation of AH-Plus, GuttaFlow, and RealSeal at apical one-third of root canals-part II: Core-sealer interface. J Conserv Dent 2018;21(1):90–94. DOI: 10.4103/JCD.JCD_127_17.
Omran AN, Alhashimi RA. The effect of AH Plus Jet® and Gutta Flow bioseal sealers on the fracture resistance of endodontically treated roots instrumented with reciprocal rotary systems. Int J Med Res Health Sci 2019;8(2):102–108. https://www.ijmrhs.com/medical-research/the-effect-of-ah-plus-and-guttaflow-bioseal-sealers-on-the-fracture-resistance-of-endodontically-treated-roots-instrumen.pdf
Trindade-Junior A, Guerreiro-Tanomaru JM, Viapiana R, et al. Influence of the gutta-percha taper and finger spreader on lateral condensation effectiveness. RSBO Rev Sul-Bras Odontol 2014;11(4):346–351. DOI: 10.21726/rsbo.v11i4.876.
Jain S, Adhikari HD. Scanning electron microscopic evaluation of marginal adaptation of AH-plus, GuttaFlow, and RealSeal at apical one-third of root canals-part I: Dentin-sealer interface. J Conserv Dent 2018;21(1):85–89. DOI: 10.4103/JCD.JCD_126_17.
Tedesco M, Chain MC, Felippe WT, et al. Correlation between bond strength to dentin and sealers penetration by push-out test and CLSM analysis. Braz Dent J 2019;30(6):555–562. DOI: 10.1590/0103-6440201902766.