Analysis of the depth of penetration of an epoxy resin-based sealer following a final rinse of irrigants and use of activation systems: An in vitro study

Abstract

Objective: The objective of the study was to compare and evaluate the depth of penetration of an epoxy resin-based sealer following a final rinse of 17% ethylenediaminetetraacetic acid (EDTA) and 18% 1-hydroxyethylidene 1, 1-diphosphonate (HEDP), with diode laser and passive ultrasonic activation (PUI): an in vitro confocal laser scanning microscopy study.

Materials and methods: Fifty-two extracted human mandibular premolar teeth with single root and single canal were selected. They were disinfected in 0.1% thymol solution, cleaned of calculus and soft tissues, and stored in 0.1% thymol solution till use. All teeth were radiographed and selected as per the inclusion and exclusion criteria. The teeth were decoronated using a diamond disk under copious water spray to acquire a standardized root length of 14 mm. Working length was established by inserting a size 10-K file into each root canal until it is visible at the apical foramen and by subtracting 1 mm from the recorded length. Instrumentation of the root canal was done till master apical file size of F3 using ProTaper universal, rotary instruments. The canals were irrigated with 2 mL of 3% sodium hypochlorite between successive files. Teeth were randomly divided into four subgroups n = 12 according to the intervention. Passive ultrasonic irrigation and diode laser were used to activate the irrigants. Final irrigation was performed with distilled water. These specimens were examined using confocal laser scanning microscope (OLYMPUS FLUOVIEW FV 3000) for dentinal tubule penetration of the sealer. Two-way ANOVA test and Tukey's multiple post hoc test were used for statistical analysis.

Results: Highly significant difference was seen between the groups with EDTA and HEDP, with HEDP demonstrating the highest penetration. Among the activation techniques used in this study, PUI showed the highest penetration of the sealer. The least penetration was seen with diode laser activation and EDTA.

Conclusions: The irrigation activation techniques significantly influence the penetration of sealer into root dentinal tubules. When penetration of sealer with different irrigation techniques and irrigants was evaluated, significant greater level of sealer penetration was attained with PUI activation of HEDP.

Keywords: 1-diphosphonate; 1-hydroxyethylidene 1; AH plus; confocal laser scanning microscope; dentinal tubule penetration; ethylenediaminetetraacetic acid; rhodamine dye.

Graph 1

Comparison of two main groups (Group 1 and Group 2) with depth of penetration

Graph 2

Comparison of two subgroups (Group 1 and Group 2) with depth of penetration

Graph 3

Comparison of interactions of two main groups (Group 1 and Group 2) and two sub groups (subgroup A and subgroup B) with depth of penetration

Figure 1

Confocal laser scanning microscope image representing the depth of penetration of AH Plus sealer after ethylenediaminetetraacetic acid and DIODE LASER activation

Figure 2

Confocal laser scanning microscope image representing the depth of penetration of AH Plus sealer after ethylenediaminetetraacetic acid and passive ultrasonic activation activation

Figure 3

Confocal laser scanning microscope image representing the depth of penetration of AH Plus sealer after 1-hydroxyethylidene 1, 1-diphosphonate and DIODE LASER activation

Figure 4

Confocal laser scanning microscope image representing the depth of penetration of AH Plus sealer after 1-hydroxyethylidene 1, 1-diphosphonate and passive ultrasonic activation activation