Comparative evaluation of the sealing ability of a bioceramic sealer (iRoot SP) with AH plus sealer with root canal dentin using three different techniques of sealer application: a combined dye extraction and scanning electron microscope study

The adaptation of a sealer along with the periphery of the dentinal tubules of the root canal is studied. Various techniques have been used for the application of these sealers onto the canal wall for better adaptation but have not been compared to date. The purpose of the study was to comparatively evaluate the sealing ability of a bioceramic sealer with AH plus sealer with root canal dentin using three different techniques for the application of sealer. One hundred twenty extracted maxillary and mandibular anterior teeth were collected, disinfected, and decoronated at the cemento-enamel junction to maintain a standard working length for all samples. The establishment of the working length (40.10) and instrumentation was performed using a rotary instrument, along with a standard irrigation regimen. The teeth were then divided into two main groups according to the sealer used, i.e., Group A (AH Plus) and Group B (iRoot SP). These two main groups were categorized into three sub-groups depending on the technique of sealer placement, i.e., Subgroup 1 (master cone gutta-percha), Subgroup 2 (bidirectional spiral), and Subgroup 3 (passive ultrasonic activation). Out of the 20 samples, 15 samples were randomly allocated for the assessment of sealing ability using the routine dye extraction method, and to verify the results of the dye extraction method, a more advanced evaluation method, i.e., SEM evaluation, was utilized further. To this end, five random samples from each subgroup were allocated for SEM analysis. The obtained scores were then statistically analyzed using an ANOVA test and Post Hoc Tukey’s test. In the current study, statistical significance was seen among the three main groups and six subgroups with p-values < 0.005. Subgroup B3 performed significantly better than the other subgroups in both the dye extraction method as well as in SEM analysis. The highest microleakage was shown by subgroup A1; it also exhibited poor penetration of sealer in SEM evaluation. The bioceramic sealer (iRoot SP), when applied using passive ultrasonic activation, showed the best results in both the dye extraction method and the SEM evaluation.