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DOI: 10.4103/ejgd.ejgd_110_20
Impact of Irrigation Solutions on the Apical Sealing Potential of Different Endodontic Sealers Used with the Continuous-wave Obturation Technique: An In vitro Study

Abstract
Aim: This study is aimed to evaluate the impact of three irrigating solutions on the apical sealing ability of three endodontic sealers. Materials and Methods: One hundred maxillary central incisors were decoronated, and their roots were assigned into three experimental groups (n = 30 each) according to the nature of the irrigating solution and two control groups (n = 5 each). Each experimental group was divided equally into three subgroups (n = 10 each) according to the type of root canal sealer. All root canals were instrumented using ProTaper Universal rotary system and irrigated with 3% sodium hypochlorite (NaOCl/Group 1), 3% hydrogen peroxide (H2O2/Group 2), and 2% chlorhexidine gluconate (CHX/Group 3). The final irrigating solutions for all groups were 17% ethylenediaminetetraacetic acid (EDTA) and distilled water. The continuous-wave technique was used to fill the prepared canals with the following materials: MTA-Fillapex/Gutta-percha (Subgroup A), AH Plus/Gutta-percha (Subgroup B), and Realseal SE/Realseal (Subgroup C). The microleakage was assessed after 72 hours using the linear dye penetration method. The results were statistically analyzed with one-way analysis of variance. Results: Significant differences were found only between the experimental groups (P < 0.05). All root canal sealers after irrigation with 3% H2O2 showed the lowest amount of leakage. The highest apical leakage was observed when 3% NaOCl and 2% CHX were used. Conclusions: The type of irrigating solution could affect the apical sealing ability of experimental sealers used with the continuous-wave obturation technique. Root canal irrigation with 3% H2O2 +17% EDTA increased the apical sealing ability of all root canal sealers. Root canal irrigation with 3% NaOCl or 2% CHX +17% EDTA decreased the apical sealing ability of all root canal sealers.
Keywords
AH plus - continuous-wave obturation technique - microleakage - MTA Fillapex. Root canal irrigation - Realseal SEFinancial support and sponsorship
Nil.
Clinically significant
The apical sealing ability of different root canal sealers is an essential parameter for the success of any obturation technique. The irrigation materials could alter the physical and chemical properties of radicular dentin and hence could the sealing ability of root canal sealers. The selection of an appropriate irrigation solution that improves the sealing ability of root canal sealers is an important clinical feature. Continuous-wave obturation technique is a popular, effective technique. The effect of three common irrigation materials (3% NaOCl, 3% H2O2, and 2% CHX) on the apical seal of different endodontic sealers (AH Plus, MTA-Fillapex, and Realseal SE) was evaluated in the current study. Only one irrigation material was evaluated each time. None of the experimental root canal sealers could prevent apical leakage after using each irrigating solution. However, the use of H2O2 showed the least amount of leakage for all sealers. The sealing ability of root canal sealers decreased when NaOCl and CHX were used. One primary recommendation is to use H2O2 as a part of irrigation protocol.
Publication History
Article published online:
01 November 2021
© 2020. European Journal of General Dentistry. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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