Medical

Communication

Biosci. Biotech. Res. Comm. 10(1): 213-218 (2017)

Experimental assessment of sealer bio ceramic wall

matching in  rst and third apical areas by scanning

electron microscope

Torabizadeh Seyed Mohammad

, Shahsiah Samira

* and Shamohammadi Milad

Resident of Endodontic Department, School of Dentistry, Jundishapur University of Medical Sciences, Ahvaz Iran

Assistant Professor Department of Endodontics, School of Dentistry, Jundishapur University of Medical

Sciences, Ahvaz Iran

Resident of Orthodontic Department, School of Dentistry, Jundishapur University of Medical Sciences,

Ahvaz Iran

ABSTRACT

This study was aimed at investigating experimental assessment of sealer bio ceramic wall matching in 1th and third

apical area by Scanning Electron Microscope (SEM).In this experimental study, thirty single root and single channel

human teeth extracted were prepared by  le rotary (FKG/Switzerland) connected to electric endodontic (Dentsply,

Maillefer, Swiss). Teeth were divided into two groups including 15 teeth: group A were obdurate with sealer bio

ceramic (BRASSELER USA Total Fill BC Sealer). Group B were  lled by sealer AH-26. Root channels were  led by

lateral compaction. All samples placed in 37 centigrade degrees and in 100 percent humidity. Sample was cut 3 mil-

limeters from apical end of root channel. Finally, SEM images were taken and wall matching level was measured.

Data were tested by one-way ANOVA and after LCD experiment they were analyzed. Results indicated that consider-

ing wall matching, there is no signi cant relation between similar section of two sealer section namely  rst section

of AH-26 sealer with  rst section of sealer bio ceramic, second section of AH-26 sealer with second section of bio

ceramic and between third sections of AH-26 sealer with third section of sealer bio ceramic while wall matching of

both sealer is similar. In sealer bio ceramic  rst section has better seal and wall matching than third section. Wall

matching of sealer bio ceramic was similar to AH-26 sealer.

KEY WORDS: WALL MATCHING, SEALER BIO CERAMIC, AH-26, SCANNING ELECTRON MICROSCOPE (SEM)

213

ARTICLE INFORMATION:

*Corresponding Author:

Received 11

Jan, 2017

Accepted after revision 27

March, 2017

BBRC Print ISSN: 0974-6455

Online ISSN: 2321-4007 CODEN: USA BBRCBA

Thomson Reuters ISI ESC and Crossref Indexed Journal

NAAS Journal Score 2017: 4.31 Cosmos IF : 4.006

reserved.

Online Contents Available at: http//www.bbrc.in/

214 EXPERIMENTAL ASSESSMENT OF SEALER BIO CERAMIC WALL MATCHING IN FIRST AND THIRD APICAL AREAS BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS

Torabizadeh Seyed Mohammad et al.

INTRODUCTION

In the past, success in endodontic treatment was identi-

 ed by three factors including debridement, steriliza-

tion, and channel obturation with equal importance for

each one. In one primitive radiography study about suc-

cess and failure, Ingle indicated that 58% of treatment

failure is due to defected obturation (Ingle et al, 1994).

Forming and cleaning trend determines decontaminated

level and ability of  lling root channel space; thus chan-

nel obturation is re ection of forming and cleaning.

Main reason of pulp and pre apical diseases is bacterial

(Kakehashi et al, 1965). Evidence show that root chan-

nel system cannot completely be cleaned and disinfected

and it is necessary to  ll root channel space in order to

elimination of leaking (Heard and Walton 1997). Obtura-

tion of channel prevents coronary leaking and bacterial

contamination and seals apex against pre apical tissue

liquids and remained drivers in the channel (Delivanis et

al.1983 and Silva Almeida et al. 2017).

Different endo dentin materials have been recom-

mended for  lling root space. Most methods use a central

material and sealer. Sealer is necessary for core material

in all methods and it provides stiff sealing against liq-

uids. Root channel sealers are necessary things for seal-

ing space of crown wall and main cone. Sealers also  ll

voids and root channel irregularity, secondary, lateral

channels and space between applied gutta-percha cones

and also they act as tripper during  lling. Some stand-

ards of an ideal sealer include: providing real connec-

tion between main material of obturation and crown,

not solving with tissue liquid during connection, being

bacteriostatic, and  nally creates an apical and lateral

and crown seal and maintains it (Grossman and Oliet

1988 and Setia et al 2014).

Sealer can be reason of root treatment failure due to

micro leakage that happens in the space between sealer,

crown, sealer and core. Chemical connection of sealer to

channel wall on one side and on the other side obtura-

tion material of gutta-percha creates a mixture of mono

block by which there is minimum channel micro leak-

age (Pawar et al 2014 ).Most popular sealers are zinc

oxide and eugenol mixtures, hydroxide calcium sealers,

glassionomer and resins. Resin sealers are AH-26 seal-

ers (Dentsply, Maillefer and Swiss) that are used for a

long time, they have adhesion property, they don’t have

eugenol and slowly stiffens (De Moor and De Bruyne

2004; Al-Haddad and Che Ab Aziz 2016; Savadkouhi

and Fazlyab 2016; Ahuja et al. 2016).

It is stated that when this combination is in the tooth

it has ability of hydroxide apatite and chemical connec-

tion. Bioceramic sealers are the most important biocer-

mics which have best role in reducing micro leakage and

increasing prognosis of root treatment by forming mono

block and chemical connection to channel wall. One

popular bio ceramic sealer is Total Fill BC Sealer pro-

duced by BRASSELER USA factory. This sealer is acces-

sible as injectable mixed paste which is based on com-

bination of silicate calcium which is unsolvable. It does

not need water for being stiffened. It does not need to be

mixed. Working time and setting time is 4 hours in room

temperature. When channel is dry, setting time reaches

to 10 hours. Most bubble and most complexity are in

 rst and third apical area of channel which has effect

on treatment prognosis (Vertucci 1984). Micro leakage

is main reason of endodentic failure which can happen

between gutta-percha and sealer, sealer and crown and

also in micro bubbles which exist in sealer. Edge match

indirectly re ects ability of sealing  ller material of root

end which is very important. Assessment of edge match

of root end  llers by scanning electron microscopy can

give information about ability of this material sealing

(Shokouhinejad et al. 2014; Ghorbanzadeh et al. 2014).

Bio ceramics of ceramic combinations are the best eco-

friendly mixtures which have been recently produced

and its contents include zirconium oxide, calcium sili-

cate, calcium phosphate, hydroxide and  ller and other,

(Pawar et al., 2014, Utneja et al. 2015; Jitaru et al. 2016

and Silva Almeida et al. 2017).

Bioceramic sealers can increase wall matching and

can reduce microleakage specially in apical area due to

formation of mono block mixture and chemical con-

nection to channel wall thus, in this study we aimed at

assessing wall matching of bioceramic sealer in  rst and

third apical areas of tooth root channel.

MATERIALS AND METHODS

PREPARATION OF SAMPLES

In this experimental laboratorial study, thirty single

root and single channel were extracted from upper jaw

and lower jaw of people due to hopeless prognise peri-

odontal. For this study double blind and teeth randomly

divided into two groups. In all groups, radiology images

were taken and they were studied considering lack of

crack, breaking, curvature, and calci cation of chan-

nel. Then teeth were  oated for 5 minutes in 5/25%

sodium hypochlorite. Consequently, remained tissues

and clean mass were washed from teeth and were kept

in normal saline. Teeth crow were cut by hand piece

with high speed under water spray. Working length was

measured by entering 15  le K  le (Dentsply, Maillefer,

Swiss) into root channel until  le top then one millim-

eter was reduced. Channels of all roots were prepared

to 35,36% taper by rotary  le connected to electric

endodential hand piece (Dentsply, Maillefer, Swiss) in all

BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS EXPERIMENTAL ASSESSMENT OF SEALER BIO CERAMIC WALL MATCHING IN FIRST AND THIRD APICAL AREAS 215

Torabizadeh Seyed Mohammad et al.

Table 1. Level of wall matching of sealer in lateral compaction in  rst and third

apical area is shown

numbermean

Standard

deviation

MinimumMaximum

Sealer AH-26

First

section

150/0340/01090/02000/0620

Second

section

150/0370/03200/01010/0920

Third

section

150/060/01860/01100/0920

Bioceramic

sealer

First

section

150/0380/01680/02000/0750

Second

section

150/0440/02190/02000/0900

Third

section

150/0540/01850/02100/0800

teeth, number 40 race was used as widener of channel

crown area while 6% race number 40 was used for mid-

dle area of channel. Then 35,6% transferred to work-

ing length. Tooth crack must not be observed in applied

rotary  les. Washing was made by 10 millimeter sodium

hypochlorite solvent, 5/25% disposable plastic syringe

with gauge 27 (BD. plastipak, India). After preparation,

root channels were washed by one-mile litter EDTA17%

and then with 5 milliliter 2/5% sodium hypochlorite for

elimination of smear layer. Finally root channels were

washed with 3 milliliters saline strilled and dried with

paper point (Dentsply, Maillefer, Swiss).

SEALING ROOT CHANNELS

Teeth are divided into two 15 teeth groups:

Group A included 15 teeth and were obturated with

35-6% gutta and sealer bioceramic ( BRASSELER USA

Total Fill BC Sealer) while their master apical gutta

was 35-6% which impregnated to bioceramic sealer

and transferred to working length. Then spreader 25

(Dentsply, Maillefer, Swiss) was transferred until it pen-

etrates. Then secondary gutta were transferred to length

of spreader in uence; this process was performed until

maximum penetration was continued to 3 to 4 mil-

limeter. Then accessible gutta were extracted by hot

chisel and remained gutta were condensed vertically in

channel span and then the hole was  lled and dress-

ing. Group B including 15 teeth were  lled by lateral

compaction and with gutta 35-6% and sealer AH-26.

While their master apical gutta was 35-6 percent which

impregnated by AH-26 sealer and it transferred to work-

ing length. Then spreader 25 was transferred until it

penetrated, and then secondary gutta was transferred

to 25% length of spreader penetration; this was contin-

ued until maximum penetration of spreader reached 3-4

millimeter. Next, accessible gutta was extracted by hot

chisel while remained gutta was condensed vertically in

channel span and the hole was wound dressed and  lled.

All samples were kept in 37

degrees and 100%

humidity for one week in order to facilitate comple-

tion of sealer setting. Sample were placed in blocks and

marked from 1 to 30. these sample were taken to cut-

ting place then three 1 millimeter sections were provided

from three millimeter root apical ( rst and third apical).

Assessment by Scanning Electron Microscope (SEM) SEM

For observing by SEM, cut parts were dehydrated. Then

samples were mounted, and sputter covered with gold

then they observed under scanning electron microscope.

In order to assess wall matching following process

was performed:

Width of marginal gap was  lled as maximum dis-

tance of material and root channel crown directly was

measured in thousandth scale by another researcher for

preventing bias.

Data were analyzed by SPSS software 20

version. In

order to compare wall matching in experimental groups

we used ANOVA test and for pairwise comparison after

experiment of LCD was applied. Level of signi cance

was p<0/05.

RESULTS

Level of wall matching of sealer in lateral compaction in

 rst and third apical area is shown in table 1:

Results of ANOVA test showed that there is signi -

cant difference wall matching among groups (p=0/005).

Results of LSD test illusterated that considering wall

matching, there is no signi cant difference between

similar section of both sealer that is mean  rst sec-

tion of AH-26 sealer( gure1) with  rst section of sealer

bioceramic( gure4), second section of AH-26 ( gure2)

Torabizadeh Seyed Mohammad et al.

216 EXPERIMENTAL ASSESSMENT OF SEALER BIO CERAMIC WALL MATCHING IN FIRST AND THIRD APICAL AREAS BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS

with second section of bioceramic ( gure5) and third

section of AH-26 sealer ( gure3) with third section of

sealer bioceramic( gure6) (p>0/05).

In AH-26 sealer, third section signi cantly enjoys

more microscopic sapce level than  rst section (p=0/001)

and second section (p=0/004) so it has less wall match-

ing. Thus  rst section had signi cantly better seal and

wall matching than than third section. Second section

has signi cantly better seal and wall matching than

third section.

Cross sections: three millimeters at the end of channel

apical in AH26 sealer group from left to right includes

 gure one to  gure three

Figure one:  rst one millimeter  gure two: second

one millimeter,  gure three third one millimeter

Cross sections: three millimeters at the end of chan-

nel apical in bioceramic sealer group from left to right

includes  gure four to  gure six

Figure four:  rst one millimeter,  gure  ve: second

one millimeter,  gure six third one millimeter

In sealer bioceramic, third section signi cantly enjoys

more microscopic space than  rst section (p=0/04) so

there is less wall matching. And  rst section has signi -

cantly better seal and wall matching than third section.

Third section of sealer bioceramic has signi cantly

microscopic space and less wall matching than  rst sec-

tion (p=0/012) and second AH-26 sealer (P=0/29). In addi-

tion, third section of AH-26 sealer has signi cantly more

microscopic space and less wall matching than  rst sec-

tion (p=0/006) and second sealer bioceramic (p=0/039).

DISCUSSION

Sealing tooth channel has main importance for preven-

tion from micro leakage and penetration bakeries into

pre apical and it is very crucial for determining prediog-

nosis of root treatment. Coronal micro leakage is consid-

ered as a vital factor in failure of root treatments. Main

factor for avoiding microleakage is applying sealers

and elimination of smear layer. For this reason, clinical

assessment of different kinds of sealers ability against

coronal penetration of bacteria’s and effect of cleaner

solvents sounds rational for puri cation of smear layer

(Farhad et al. 2007). Using sealers with appropriate

properties including connection, matchless, and tubule

penetration has two positive consequences: First, cre-

ating seal in channel due to higher interface f sealer

with crown wall; second burial of remained batteries in

crown tubules which in fact it is anti-bacterial effect of

sealers (Mohammadian et al. 2017).

Aim of this study was to investigate experimen-

tal assessment of sealer bioceramic wall matching in

1th and third apical area by Scanning Electron Micro-

scope (SEM). Gutta percha is in connection with sealers

and it is most common applied  ller in root channel

(Mohammadian et al. 2017). So in this study, in order

FIGURE 1. FIGURE 2. FIGURE 3.

FIGURE 4. FIGURE 5. FIGURE 6.

Torabizadeh Seyed Mohammad et al.

BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS EXPERIMENTAL ASSESSMENT OF SEALER BIO CERAMIC WALL MATCHING IN FIRST AND THIRD APICAL AREAS 217

to  ll root channel, gutta percha has been used.In this

study, cold lateral compaction method was used because

this method is the most common place method for obu-

ration of channel. This method is able to be used in most

clinical conditions and it provides controlling during

obturation (Cailleteau and Mullaney 1997; Anantula

and Ganta 2011; Kumar et al. 2012). In addition, cold

lateral compaction method is golden standard in endo

dentic (Anantula and Ganta 2011; Kumar et al. 2012).

Existence and nonexistence of smear layer has main

role in apical seal created by different method of obtura-

tion. Studies indicated that smear layer can act as a way

for leakage of micro-organism and it can be as a source

for growth and activities of different bacteria’s in crown

tubules (Kumar et al. 2012). Hence, in this study root

with 5/25% sodium hypoclorit solvent and 17% EDTA

were disinfected for elimination of smear layer.

In this study for assessing wall matching, SEM was

used. Because it has higher accuracy and ability of bet-

ter magni cation in interface. SEM uses electromagents

insteade of lenzes so it provides chance of more con-

trol on level of magni cation for the reseearche and at

results images are provided more transparent (Punitha P

and Shashikala K. 2011).

Results indicated that considering wall matching,

there is no signi cant relation between similar section of

two sealer section namely  rst section of AH-26 sealer

with  rst section of sealer bioseramic, second section

of AH-26 sealer with second section of bioceramic and

between third sections of AH-26 sealer with third sec-

tion of sealer bioceramic while wall matching of both

sealer is similar. In sealer bioceramic  rst secton has bet-

ter seal and wall matching than third section. Produc-

ers claim that hydrophilic characteristic of endodentic

points of polymeric use remained humidity and form

self-sealing on setting radially and without develop-

ing in axial orientation. While alkaline nature of most

bioceramic products change crown collagen  bers and

facilitates sealers penetration to crown tubules.

In this study, it was observed that penetration of sealer

bioceramic Total Fill BC is similar to resin sealer AH-26.

Mohammadian et al (2017) reported that in root apical

area ,considering sealer interface with crown, there is no

signi cant difference between two sealer bioceramic BC

and resine sealer AH-plus.

In another study, by Pawar et al (2014) have indicated

that sealer bioceramic endosequence and resin sealer

resilon epiphany enjoys better apical seal in compare

to AH-Plus resin sealer. However in this study in order

to measure seal they used color penetration method.In

study of SEM by Polineni et al (2016) considering wall

matching MM-Seal resin sealer has the least gap level byt

there was no difference between MM-Seal resin sealer

with Endosequence sealer bioceramic.Interface of sealer-

crown is a crucial area in sealed root channels. Sealers

with epoxy resin and bioceramic are not shrinked during

setting and it can be the reason of appropriate matching

in gap between crown and sealer in compare to sealers

based on eugenol,(Mohammadian et al. 2017).

In this study in AH-26 sealer third section signi -

cantly enjoyes more microscopical space than  rst sec-

tion (p-0/001) and second (p-0/004) so has less wall

matching. Thus,  rst section has better wall matching

than third section. Second section has signifcantly bet-

eer seal and wall matching than third section. In sealer

bioceramic, third section signi cantly has more micro-

scopic space level than  rst section (p-0/04) so has less

wall matching. Hence,  rst section signi cantly has bet-

ter seal and wall matching than third section.

Results ilusterated that third section of Total Fill

BC bioceramic sealer has signi cantly more microsco-

pial space and less wall matching than  rst and second

sections of AH-26 sealer. In addition, third section of

AH-26 sealer has signi cantly more microscopial space

and less wall matching than  rst and second sections

of Total Fill BC bioceramic sealer. These results can be

due to difference of different sections of root in apical

area. Polineni et al (2016), using SEM, coronal sections

showed that it enjoys more wall matching as compared

to apical sections.

This difference between coronal and apical level can

be due to less compaction and more diameter of crown

tubule in apical level which cause less perpetration of

sealer. Moreover, elimination of smear later in one third

apical area is problematic and it may act as physical

obstacle which is interference of sealer to root channel

crown (Polineni et al. 2016).

Generally, it must be considered that leakage totally

cannot be eliminated from treated root channels; lateral

and additional channels and other anatomic differences

along with periapical pressure have main role as pro-

gressive factor.

Considering that the areas which are commonly unaf-

fected by instrumentation and irrigation during root

canal preparation, where a more viscous material like

sealer can’t reach, can open up spaces for leakage and

decrease the chances of success.

CONCLUSION

Results indicated that there is no signi cant differ-

ence between similar sections of both sealer it means

that considering wall matching,  rst section of AH-26

sealer with  rst section of bioceramic sealer Total Fill

BC, second section of AH-26 sealer with second section

of sealer bioceramic sealer Total Fill BC and third section

of AH-26 sealer with third section of sealer bioceramic

Torabizadeh Seyed Mohammad et al.

218 EXPERIMENTAL ASSESSMENT OF SEALER BIO CERAMIC WALL MATCHING IN FIRST AND THIRD APICAL AREAS BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS

total Fill BC. In sealer bioceramic total Fill BC  rst sec-

tion has signi cantly better seal and wall matching than

third section.

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