Assessment of dentinal tubule penetration of AH plus, MTA Fillapex and Sealapex after various disinfection procedures: A confocal laser scanning microscopic study

Year 2023, Volume: 33 Issue: 1, 20 - 26, 31.01.2023

Recai Zan Kerem Engin Akpınar Hüseyin Sinan Topcuoğlu İhsan Hubbezoğlu Arzu Şeyma Demir

https://doi.org/10.5152/crds.2022.6238

Abstract

ABSTRACT
Objective: The aim of this study is to evaluate and compare dentinal tubule penetration of various root canal sealers obturated after the application of different irrigation activation procedures by a laser scanning confocal microscope.
Methods: A total of 150 extracted human permanent mandibular premolar single-rooted teeth were selected and randomly divided into 3 main groups according to the sealer type (n = 50) as AH Plus, MTA Fillapex, and Sealapex. Each main group was randomly subdivided into 5 subgroups according to the irrigation activation protocols (n = 10): Potassium–titanyl–phosphate laser irradiation, conventional needle, intra-kit, sonic irrigation, and ultrasonic irrigation procedures. After the activation procedures, the root canals were obturated with AH Plus, MTA Fillapex, and Sealapex mixed with 0.1% fluorescent rhodamine B isothiocyanate. Specimens were sectioned at 3, 6, and 9 mm from the apex. All sections were examined under a confocal laser scanning micro- scope to calculate the dentinal tubule penetration area.
Results: Data were analyzed using a 3-way analysis of variance and Tukey’s post hoc tests (P = .05). Sealapex indicated a statistically lesser penetration than the other group (P < .05), MTA Fillapex ensured deeper penetration than AH Plus (P < .05). Ultrasonic irrigation provided sig- nificantly deeper penetration than other activation procedures (P < .05). The statistically high- est percentage and the maximum depth of sealer penetration were shown in coronal third for all groups (P < .05).
Conclusion: The selection of root canal sealer, irrigation activation procedures, and root canal region plays a crucial role on the dentinal tubule penetration. AH Plus and MTA Fillapex applied with ultrasonic irrigation could achieve deeper sealer penetration in dentinal tubules.
Keywords: Dentin tubule penetration, confocal laser scanning microscopy, irrigation activation, root canal treatment

ÖZ
Amaç: Bu çalışmanın amacı, farklı dezenfeksiyon tekniklerinin uygulanmasından sonra uygulanan çeşitli kök kanal patlarının dentin tübüllerine penetrasyonunu bir konfokal lazer tarama mikros- kobu kullanarak değerlendirmek ve karşılaştırmaktır.
Yöntemler: 150 adet çekilmiş insan daimi mandibular premolar tek köklü dişler seçildi ve rastgele olarak patların tipine göre AH Plus, MTA Fillapex ve Sealapex olarak 3 ana gruba ayrılmıştır (n = 50). Her grup irigasyon aktivasyon prosedürüne göre rastgele olarak beş altgruba ayrılmıştır (n = 10); KTP lazer ile ışınlama, geleneksel, intra-kit, sonik (Sİ) ve ultrasonik aktivasyon (Uİ) prosedüreleri
Aktivasyon prosedürlerinin ardından kök kanalları % 0.1 floresan rodamin B izotiyosiyanat ile karıştırılmış AH Plus, MTA Fillapex ve Sealapex patlar ile dolduruldu. Örnekler apeksten itibaren 3, 6, ve 9 mm kesitler alındı. Bütün kesitler dentin tübül penetrasyonu alanını hesaplamak için bir lazer taramalı konfokal mikroskop altında incelendi. Veriler varyans üç yönlü analiz ve Tukey testleri kul- lanılarak analiz edildi (P = ,05).
Bulgular: Sealapex diğer gruplara göre anlamlı derecede düşük penetrasyon gösterdi (P < ,05). MTA Fillapex, AH Plus’a göre daha derin penetrasyon sağlamıştır (P < ,05), Uİ diğer dezenfeksiyon tekniklerine göre önemli ölçüde daha derin penetrasyon sağlamıştır (P < ,05). Tüm gruplarda koronal üçlüde, istatiksel olarak en yüksek oranda ve maksimum pat penetrasyon derinliği görülmüştür (P < ,05).
Sonuç: Kök kanal patı seçimi, irigasyon aktivasyon prosedürü ve kök kanal bölgesi dentin tübül penetrasyonu üzerine önemli bir rol oynamaktadır. Ultrasonik aktivasyonla birlikte uygulanan AH Plus ve MTA Fillapex ile dentn tübüllerinde daha derin pat penet- rasyonu elde edilebilir.
Anahtar Kelimeler: Dentin tübül penetrasyon, lazer taramalı konfokal mikroskop, irigasyon aktivasyon, kök kanal tedavisi

Keywords

Dentin tubule penetration, confocal laser scanning microscopy, irrigation activation

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