Comparative Evaluation of Apical Sealing Efficacy of Guttaflow Bioseal, Super-Bond Rc Sealer and Adseal Root Canal Sealer.

Objectives: The objectives of this study is to evaluate apical sealing ability of GuttaFlow Bioseal, Super-Bond RC Sealer, and Adseal root canal sealer. Material and
Methods: 36 extracted human single rooted permanent teeth, divided into three groups (n = 12) and obturated by lateral condensation technique. Obturation and root canal sealing was done by either Group I: using GuttaFlow Bioseal, Group II: using Super-Bond RC Sealer and Group III: using Adseal sealer, system. Microleakage was assessed by means of dye penetration method.
Results: The dye penetration in Group II was more than in Groups I and III in both vertical and horizontal directions, suggesting that GuttaFlow Bioseal and Adseal sealer are effective in reducing the apical leakage compared to Super-Bond RC Sealer.
Conclusion: Bioceramic GuttaFlow Bioseal root canal sealers seal are better root canal sealer but they cannot totally eliminate apical leakage. Copyright:

INTRODUCTION

A root canal sealer plays a significant role in controlling endodontic procedure and prevents root canal leakage.[1] At present, various types of root canal sealers are available including zinc oxide eugenol, glass ionomer, calcium hydroxide, silicone, Epoxy resin, Tricalcium silicate (MTA/Bioceramic), Methacrylate resin, and bioceramic based sealers.[123]

The major function of endodontic sealers are sealing off of voids, accessory canals, and foramina, forms bonding between the obturating material and the root canal wall, and acts as a lubricant and helps in placement of the root canal filling.[1]

Epoxy resin based sealers are usually used as gold standard endodontic sealers due to its adequate radiopaque, high bond strength to dentine, dimensional stability, flow, low solubility and high resistance. They are commercially available as AH 26, AH Plus, and Adseal.[4] The main advantages related with the use of bioceramic materials is; their biocompatibility which avoids rejection by the surrounding tissues.[12]

The present in vitro study was done to evaluate the apical sealing ability of GuttaFlow Bioseal, Super-Bond RC Sealer, and Adseal root canal sealer.

MATERIALS AND METHODS

Thirty-six extracted human single rooted permanent teeth, divided into three groups (n = 12) and obturated by lateral condensation technique. Obturation and root canal sealing was done by either Group I: with GP, GuttaFlow Bioseal (GFB) (Coltène/Whaledent AG, Altstätten, Switzerland),- (Bitoceramic based sealer), Group II: with GP, Super-Bond RC Sealer (Accel) (Sun Medical, Japan) (Methacrylate resin-based sealer), and Group III: with using Adseal (Meta Biomed, Korea) (Epoxy resin-based sealer).

Microleakage was assessed under stereomicroscope at 40×magnification by means of dye penetration method after suspension of specimens in 1% methylene blue for 48 hrs.

The results were statistically evaluated using SPSS version 22.0 with one way Analysis of Variance (ANOVA) and Tukeys multiple post hoc.

RESULTS

Table 1 indicates comparison of vertical dye penetration among test groups. The difference among the group was highly statistically significant (p- 0.0002) with F value of 7.373.

Table 1

Comparison of vertical dye penetration among test groups

Source of variation	Degrees of freedom	Sum of squares	Mean sum of squares	F	P
Between groups	2	75.34	32.7788	7.373	0.0002*
Within groups	34	256.76	3.3467
Total	36	346.28

*P<0.05 significant, test used: one way ANOVA

Table 2 indicates pair wise comparison with respect to vertical penetration of dye among three groups. It was statistically significant between Group II with I (P = 0.0002*) and Group III with Group II (P = 0.0500*).

Table 2

Pair wise comparison with respect to vertical penetration of dye among three groups

Groups	I	II	III
Mean	4.2314	7.0531	5.3487
SD	1.3725	2.0237	2.7975
I GuttaFlow Bioseal	-
II Super-Bond RC Sealer	P=0.0002*	-
III Adseal sealer	P=0.1325	P=0.0500*

*P<0.05, Test used: Tukeys multiple post hoc procedures

Table 3 indicates pair-wise comparison of three groups showed, at 2 mm, the results were not significant, but at 3 mm and 5 mm there was a significant (P < 0.05) difference except for group I vs C at 5 mm.

Table 3

Comparison of horizontal penetration of dye at 2 mm, 3 mm, and 5 mm length scores with 3 groups

Group	Mean µm	Std. deviation	P
2 mm			0.0946
I	24.32a	5.79
II	30.28a	4.26
III	27.74a	3.64
3 mm			0.0001*
I	23.27q	7.76
II	30.64p	4.76
III	25.84r	3.56
5 mm			0.0001*
I	8.69a	6.53
II	14.86b	4.08
III	9.64a	5.78

a,b,c,p,q,r Different lower case letters indicate a statistically significant difference. P<0.05, test used: one way ANOVA

DISCUSSION

For successful endodontic therapy, proper sealing of the root canal system is necessary.[13] The apical sealing ability of different sealers can be assessed by various methods such as dye penetration method, antibacterial effect, microinfiltration evaluation, or use of electronic scanning microscopy.[3]

Asawaworarit et al.,[4] found EndoSequence BC Sealer had significantly better sealing ability than AH Plus. Pawar et al.[5] found higher microleakage with AH Plus sealer compared to Endosequence bioceramic (BC) sealer and Epiphany system. Pawr et al. found better efficacy with Endosequence bioceramic (BC) sealer.[5] Salem et al.,[6] found similar sealing ability among Total Fill BC and AH Plus in apical sealer.

In the present study, apical microleakage was higher in Methacrylate resin-based Super-Bond RC Sealer. The good adaptability of the epoxy resin sealer might be due to its ability to bond to root dentine chemically.[6]

Lower microleakage found with bioceramic sealer since, it sealers can penetrate into the dentinal tubules and polymerize, forming a hybrid layer.[3]

The drawback of the present study was smaller sample size and the study was in vitro evaluation. Further studies are necessary to elucidate the clinical outcomes related with the use of these sealers.

CONCLUSION

Within the limitations of the current study, we can conclude that the bioceramic sealer showed good apical sealing with lower microleakage. Bioceramic GuttaFlow Bioseal root canal sealers seal are better root canal sealer but they cannot totally eliminate apical leakage.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.