title: Dentinal tubule penetration of AH Plus, iRoot SP, MTA fillapex, and guttaflow bioseal root canal sealers after different final irrigation procedures: A confocal microscopic study.
abstract: OBJECTIVE
  Varied physical and chemical characteristic of root canal sealers and different irrigant agitation systems can influence the depth of penetration. The aim of this in vitro study was to use a laser scanning confocal microscope in order to assess the dentinal tubules penetration of various sealers after the application of different final irrigation techniques.
  
  
  METHODS
  A total of 156 single-rooted extracted mandibular premolars were prepared up to size 40 and randomly distributed into four groups according to the sealer type (n = 39): AH Plus, iRoot SP, MTA Fillapex, and GF Bioseal. Each group was randomly subdivided into three groups according to the final irrigation protocol (n = 13): conventional needle irrigation (CI), photon-induced-photoacoustic streaming activation (PIPS), and passive ultrasonic irrigation (PUI). After the final irrigation procedures, the root canals were obturated with single gutta-percha and labeled sealer mixed with 0.1% fluorescent rhodamine B isothiocyanate. Specimens were sectioned at 2, 5, and 8 mm from the apex, and all the sections were examined under confocal microscope to calculate the dentinal tubule penetration area. Data were analyzed using three-way analysis of variance and Tukey's post hoc tests (P = 0.05).
  
  
  RESULTS
  iRoot SP exhibited a significantly higher penetration area than the other groups (P < 0.001), although there were no statistically significant differences between AH Plus, MTA Fillapex, and GF Bioseal (P > 0.05). Er:YAG laser activation with PIPS and PUI had significantly higher penetration than CI (P < 0.001). Statistically significant differences were also determined at each root canal third (coronal > middle > apical; P < 0.001).
  
  
  CONCLUSIONS
  The dentinal tubule penetration area was significantly affected by the selection of root canal sealer, final irrigation procedure, and root canal third. Use of iRoot with PIPS tip or PUI seems advantageous in dentinal tubule penetration.
authors.affiliation: Faculty of Dentistry, Department of Pedodontics, Izmir Katip Celebi University, Izmir, Turkey.
authors.forename: Merve
authors.initials: M
authors.lastname: Akcay
authors.affiliation: Faculty of Dentistry, Department of Endodontics, Ataturk University, Erzurum, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Arslan
authors.affiliation: Faculty of Dentistry, Department of Pedodontics, Izmir Katip Celebi University, Izmir, Turkey.
authors.forename: Nazli
authors.initials: N
authors.lastname: Durmus
authors.affiliation: Faculty of Dentistry, Department of Pedodontics, Izmir Katip Celebi University, Izmir, Turkey.
authors.forename: Merve
authors.initials: M
authors.lastname: Mese
authors.affiliation: Faculty of Dentistry, Department of Endodontics, Izmir Katip Celebi University, Izmir, Turkey.
authors.forename: Ismail Davut
authors.initials: ID
authors.lastname: Capar
mesh_terms: D017607:Aluminum Compounds; D017610:Calcium Compounds; D003804:Dentin; D004129:Dimethylpolysiloxanes; D004338:Drug Combinations; D004853:Epoxy Resins; D006171:Gutta-Percha; D006801:Humans; D066298:In Vitro Techniques; D018613:Microscopy, Confocal; D010087:Oxides; D011897:Random Allocation; D012387:Root Canal Filling Materials; D012388:Root Canal Irrigants; D017640:Silicates; D007507:Therapeutic Irrigation / Q000379:methods*; D015035:Zinc Oxide-Eugenol Cement
chemical_list: D017607:Aluminum Compounds; C097428:Bioseal; D017610:Calcium Compounds; D004129:Dimethylpolysiloxanes; D004338:Drug Combinations; D004853:Epoxy Resins; C515718:GuttaFlow; D010087:Oxides; D012387:Root Canal Filling Materials; D012388:Root Canal Irrigants; D017640:Silicates; D015035:Zinc Oxide-Eugenol Cement; C112894:canals sealer; C534916:epoxy resin-based root canal sealer; C000600177:iRoot BP Plus; C086631:mineral trioxide aggregate; D006171:Gutta-Percha
keywords: GuttaFlow Bioseal; MTA Fillapex; PIPS; confocal; dentinal tubule penetration; iRoot SP