An in vitro, SEM and micro-CT comparison of dentinal tubule penetration and void formation by four bioceramic sealers in premolars

Abstract

Introduction: Bioceramic sealers are receiving substantial attention because of their favourable physicobiological properties. Studies have shown that the use of materials containing calcium-silicates results in the formation of a crystalline structure similar to tooth and bone apatite, which is favourable in the healing of endodontic lesions. Aim: The aim of this study was to compare the sealing ability of four bioceramic sealer materials, available commercially in South Africa, by measuring the formation of voids at three levels (coronal, middle and apical). Materials and Methods: In this study, four different bioceramic sealers (BioRoot RCS, CeraSeal, TotalFill, and AH Plus Bioceramic [BC]) were compared. Single rooted premolars were included. Coronectomies were performed on each tooth and the root canals were prepared using reciprocating instruments. The canal was then obturated using a single gutta-percha point and one of the four specified root canal sealers. The sealers were allowed to set, after which the obturations were analysed and compared using microcomputed tomography (micro-CT) to evaluate void formation. Results: For the overall average of all three positions (coronal, middle, and apical), the mean surface area of voids of the four sealers did not differ significantly (p>0.05). The overall median surface area of voids for AH Plus BC and BioRoot differed significantly (p=0.049). Conclusion: None of the four tested bioceramic sealers demonstrated void-free fillings and voids were found in all samples to varying degrees.